# Lameness, over at knee, buckling



## Ryle (Jul 13, 2007)

Have you done x-rays of anything but the feet? Have you had a good full-body exam that looks for pain in other areas than just the lower leg?


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## RedHorseRidge (Nov 3, 2012)

We have xrayed her knees, but it's been awhile; I'll probably have that done again when the vet comes out, but I don't expect it to show anything. The vet checked her back, shoulders, etc. and did some flexion testing two months ago, but didn't find anything.


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## tinyliny (Oct 31, 2009)

is this an OTTB? how long have you had her, and always been this way?

there's a system of balancing and counter balancing ligaments and tendons that work together to make the hrose able to "lock" their legs so they can sleep standing up. when that gets out of balance, the locking mechanism doesn't work well. I do not remember the details, just read about it in an article by Deb Bennet in Equus magazine.


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## RedHorseRidge (Nov 3, 2012)

I've had her for ten years; she's a mountain horse. She hasn't always had this issue. I had a farrier that wasn't trimming her correctly (left her heels way too high) and her heels started to contract. For a few years, she has been somewhat ouchy on her heels (slow going down hills, etc.) but I shoe her when I trail ride in the summers and that has always seemed to relieve any tenderness in her heels. But she's never visibly trembled with her knees buckling like this.

Because she has had heel pain before, I can't help but think that is the problem, but we can't pinpoint anything. She does have some "butt cracks" in her heels that we've been treating, just in case.


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## tinyliny (Oct 31, 2009)

I see. so, not what I was thinking.


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## Smilie (Oct 4, 2010)

My first thoughts would have been laminitis, but you say that has been ruled out-how?
Standing with feet under her-hind feet?
showing increased lameness when turning, as in reluctance to step around with front feet, is pretty classic for laminitis
Or, does she stand with front feet under her?
How does she land-toe first, or heel?
I guess if your vet could not diagnose her, doubt anyone can give you the answer over the internet.
Have you tried an equine vet center that specializes in PPE and lameness exams?


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## RedHorseRidge (Nov 3, 2012)

Laminitis has been ruled out by the vet and farrier via xrays and hoof testing and pulse taking and heat monitoring (with a laser thermometer). She stands with her feet under her and has a definite toe first landing. Navicular has been ruled out as well via the xrays. 

I'm just looking to see if anyone has come across anything similar so we can at least have something else to try. One person has contacted me and suggested it might be neurological. Another has suggested it could be deep central sulcus thrush (as his horse was very lame from that with not very much of a heel crack). 

We have talked to the vet about hauling her into Leesburg. The vet wants to do more blood work this spring to rule out Cushings first.


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## Ryle (Jul 13, 2007)

Is she able to flex her neck well?


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## Patty Stiller (Aug 7, 2012)

> She stands with her feet under her and has a definite toe first landing. Navicular has been ruled out as well via the xrays.


good close up photos of the hooves taken level from the sides (camera ON the ground) and straight on at the soles would be extremely helpful. 

Usually that stance is indicative of the horse compensating for certain kinds of hoof imbalance. 
Often hoof imbalance directly affects the equilibrium of the the tendons and ligaments of the leg and is being compensated for by the horse. Even without clinical heel pain. And most vets are unaware of this issue. By the way horses with navicular pain almost always stand with the hooves placed FORWARD , not back. Horses with *extensor tendon* discomfort from high heels stand BACK. As well as a few horses with sinking (not rotating) type laminitis.


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## Patty Stiller (Aug 7, 2012)

And the toe landing also accompanies hoof imbalances.


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## RedHorseRidge (Nov 3, 2012)

Ryle said:


> Is she able to flex her neck well?


I actually checked her neck this morning (as she does have an odd "muscle lump" on lower on the right side of her neck that she has had since she was born). No issues at all.

Someone told me their horse had similar issues (trembling and weakness on the front end) and it turned out to be a tumor that was growing in on the side of her neck that affected her spine.


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## RedHorseRidge (Nov 3, 2012)

Patty Stiller said:


> good close up photos of the hooves taken level from the sides (camera ON the ground) and straight on at the soles would be extremely helpful.
> 
> Usually that stance is indicative of the horse compensating for certain kinds of hoof imbalance.
> Often hoof imbalance directly affects the equilibrium of the the tendons and ligaments of the leg and is being compensated for by the horse. Even without clinical heel pain. And most vets are unaware of this issue. By the way horses with navicular pain almost always stand with the hooves placed FORWARD , not back. Horses with *extensor tendon* discomfort from high heels stand BACK. As well as a few horses with sinking (not rotating) type laminitis.


Patty,

Thanks,

I've posted some photos from the side, the back, and the sole. (She is about 6 weeks since her last trim and due in the next week or two.)

http://i344.photobucket.com/albums/p328/fishing_trex/an4_zpsnmyw7ats.jpg
http://i344.photobucket.com/albums/p328/fishing_trex/an1_zpsj9vun3pc.jpg
http://i344.photobucket.com/albums/p328/fishing_trex/an2_zpsclqibxtd.jpg
http://i344.photobucket.com/albums/p328/fishing_trex/an3_zps1mr4cirz.jpg


She has always had very concave feet with deep grooves. I've been stuffing the crack in her heel with Tomorrow and cotton balls, which I removed for the photo.


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## Dapples123 (Jan 9, 2015)

We have a horse at our barn who is over the knee and cannot sleep standing up - her knees don't lock. If she does doze a bit, her legs will buckle. If you pick up one of her front legs, the other will vibrate.

I have a gelding who is over the knee. He can lock his knees to sleep but, working with my vet and farrier, we have done a couple of things to help take the pressure off the tendons in the back of the cannon bone.

First off - my vet says that the vibration is normal for over-the-knee horses. 

My farrier trims the fronts short, leaves heel and then, when he puts the shoe on, he attaches the shoe back from the tip of the hoof - about a 1/4 inch back. That helps take the pressure off the tendons. He does have a very stiff neck - it's affected by the way he goes as his legs obviously cannot travel correctly so he's always trying to balance himself.

Yours sounds like a much more heavy-duty issue but, I wanted to pass along what we do for my guy as it has helped him throughout the years. He's 20 now and still happily jumps little crossrails and can do trails. 

I hope everything works out!


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## RedHorseRidge (Nov 3, 2012)

Dapples, thanks! 20 and still doing trails... wow. Our 22YO has arthritis so we quit riding her.

My farrier will also trim the front short and set the shoe back (we use plastic shoes). When we first did this, it seemed to really make a difference. But the last time (October), not so much, so we decided to pull them for the winter. 

Makes sense that if a horse can't lock its knees that it might vibrate when one is picked up...


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## Patty Stiller (Aug 7, 2012)

well the biggest issue with the hooves is some seriously too long heels. It could well be causing the problems but even if not, it certainly will not hurt to correct it. However you need a farrier who knows how to "map" a hoof and trim around that instead of doing this more 'traditional' trim. The farrier MUST NOT lower the heels without ALSO bringing the breakover point of the toe rearwards at the same time.it is a bakancing process that involves the WHOLE foot. 
As well sometimes there can be small issues in the ligaments inside the hoof, around the coffin joint that are not easily diagnosed. Those can respond well to a different trimming approach as well as certain kinds of therapeutic shoeing, But looking at these heels and toe, I would be startng with the trim and working from there.


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## Smilie (Oct 4, 2010)

far as the stance and laminitis, I was referring to the hind legs being under the horse, and yes, front legs are extended, and horse walks in an 'egg shell' manner
I did not get a picture as to which legs the horse stood , so that they were under body
The heels do not look balanced, and bar is distorted. I agree some hoof mapping would be a good idea


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## Smilie (Oct 4, 2010)

That left bar really bothers me. If you look where the last weight baring surface is in that heel area, it sure looks migrated forward in that sole shot.


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## Smilie (Oct 4, 2010)

RedHorseRidge said:


> Laminitis has been ruled out by the vet and farrier via xrays and hoof testing and pulse taking and heat monitoring (with a laser thermometer). She stands with her feet under her and has a definite toe first landing. Navicular has been ruled out as well via the xrays.
> 
> I'm just looking to see if anyone has come across anything similar so we can at least have something else to try. One person has contacted me and suggested it might be neurological. Another has suggested it could be deep central sulcus thrush (as his horse was very lame from that with not very much of a heel crack).
> 
> We have talked to the vet about hauling her into Leesburg. The vet wants to do more blood work this spring to rule out Cushings first.


What about Navicular syndrome? Soft tissue damage always occurs before bony changes, and would not show up on x-ray. 
So, front feet are under her , when she stands.
Some horses with caudal foot pain will also stand with fetlock flexed forward, on the foot that bothers them the most at the time, avoiding loading the heel area.

tHIS:

Navicular Stance - A horse with navicular has chronic pain at the back part of the hoof. This results in the front hooves usually being placed well underneath the horse(backward of where the leg would normally be placed) to help reduce the load applied to that painful area.

tHUS, looking at the heels and the way the horse stands, I would still guess caudal foot pain, whether actual navicular changes in the bone are not present yet, and thus focus on navicular syndrome


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## RedHorseRidge (Nov 3, 2012)

Patty, thanks. She grows heel really fast (bars too), and she is due for a trim, as I said, in the next week or two. I'll discuss with the farrier regarding bringing the break over point back as she lowers the heels. We're probably going to put shoes on her this next time. The last time we did this we moved the shoe back (as I mentioned) to move the breakover back. 

Smilie, she's been xrayed for navicular twice... nothing. 

Thanks to everyone who has responded; I really appreciate it.


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## jazzy475 (Sep 18, 2014)

RedHorseRidge said:


> Patty, thanks. She grows heel really fast (bars too), and she is due for a trim, as I said, in the next week or two. I'll discuss with the farrier regarding bringing the break over point back as she lowers the heels. We're probably going to put shoes on her this next time. The last time we did this we moved the shoe back (as I mentioned) to move the breakover back.
> 
> Smilie, she's been xrayed for navicular twice... nothing.
> 
> ...


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## loosie (Jun 19, 2008)

Hi OP, Have so far only read first page, and tried to open links to pics - one has opened, they taking forever, and it would be much easier if you could post pics in thread, rather than photobucket links to each pic.

From what you've told, I too would be thinking heel pain is most likely, and just because a vet & farrier have said feet are OK, that she tolerated hoof testers doesn't necessarily mean there is not problem, unfortunately.

If she is shod, she will indeed be more comfortable, but if she's shod without heel support/protection, then it won't be helping her heels improve and avoid further damage.


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## loosie (Jun 19, 2008)

Hi OP, Have so far only read first page, and tried to open links to pics - one has opened, they taking forever, and it would be much easier if you could post pics in thread, rather than photobucket links to each pic.

From what you've told, I too would be thinking heel pain is most likely, and just because a vet & farrier have said feet are OK, that she tolerated hoof testers doesn't necessarily mean there is not problem, unfortunately. If she did have high, contracted heels, then chances are there is some weakness in her heels still. That she came down with (clinical, I assume?) laminitis last year just from a change of weather suggests that she may have been borderline or 'subclinical' & had metabolic issues for some time and the cold snap was a 'final straw'.

If she is shod, she will indeed be more comfortable, but if she's shod without heel support/protection, then it won't be helping her heels improve and avoid further damage.


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## Smilie (Oct 4, 2010)

Op:
'Smilie, she's been xrayed for navicular twice... nothing.

THat was my point, when I stated that although the navicular bone might show clean x-rays, x-rays themselves won't show soft tissue damage in that caudal part of the foot. Soft tissue damage always occurs before changes to the navicular bone itself
That is also why 'navicular syndrome ' is used now , for caudal foot pain
That is also why many horses with severe caudal foot pain have normal x-rays and some with changes to the navicular bone, are sound
Thus, unless you had other diagnostics to rule out soft tissue damage, you can't say that the horse does not have navicular syndrome.


This, from Pete Ramey's site on Navicular syndrome
You can read the entire article, but I will just copy this pertinent part, which explains why horses with clean x-rays can have severe navicular syndrome

We’ve known for many years that some horses with navicular bone changes are perfectly sound, while many horses without such damage to the navicular bone show severe lameness at the back of the foot. It has long been assumed, though that damage to the navicular bone happened first, either because of a mysterious degenerative disease, a lack of circulation, or as I stated in my book (Making Natural Hoof Care Work For You) the result of the body reacting to unnatural pressure in that region. I can still buy two out of those three as being *part* of what’s happening (the degenerative disease part is dead wrong for sure). It has long been assumed that the pain of navicular syndrome is being caused by the friction on the already damaged navicular bone by the deep flexor tendon. It was assumed that this friction with a rough surface then damaged the deep flexor tendon. I wondered years ago how this could be so. It would increase pain dramatically if this were the case, for a horse to voluntarily land toe first. The only way he could move this way, would be to hang all of his weight by the deep flexor in the very pulley system that is supposed to be hurting him!  
[Edited by James R. Rooney]
In thousands of dead horses he examined, Dr. Rooney found that the fibrocartilages surrounding the flexor tendon and the navicular bone were ALWAYS damaged if bone remodeling was present. He found *not one single case* in which the damage to the bone was beginning, and the cartilages at the interface between the navicular bone and the deep flexor tendon were not yet damaged. Not one case in thousands. Read this again if your eyebrows didn’t go up. 
 Specifically, the order in which damage occurs is; first the fibrocartilage surrounding the navicular bone (as will any arthrosis begin on the more convex surface), second the fibrocartilages surrounding the deep flexor tendon, then the deep flexor itself, and finally the navicular bone is damaged by the rough surface of the damaged deep flexor tendon. How? Why? Dr. Rooney wondered too. Simulating a *toe first landing* in test machines with dead horse legs, he was able to simulate this exact process that is the beginning of navicular bone remodeling.


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## loosie (Jun 19, 2008)

Smilie said:


> Op:
> 'Smilie, she's been xrayed for navicular twice... nothing.


Has she been ultrasounded for it? Good if damage hasn't gone far enough to make for bony changes yet, but...

BTW, sorry for double post - edited it to add & then it posted both & told me I was out of time to change!


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## Dapples123 (Jan 9, 2015)

I would get a really experienced farrier to help. If I took the shoes off my guy, he wouldn't last a half day without becoming very sore. 
Perhaps the shoeing in the fall wasn't done correctly (?). 

And, I get his hooves trimmed and shoes reset every six weeks - if I don't, the shoe slowly moves into the wrong place to balance out the pressure. Even at six weeks, I can tell a difference when I ride him right after the farrier has done a trim.


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## angelswave88 (Mar 18, 2015)

I recently had a PPE done on a horse I was interested in several months ago. When I walked in for the exam, it slapped me in the face how unstable his front legs looked. He was a 16 year old OTTB. Even when just standing square, his front legs would look like they were shivering or quaking. Also looked like he had "weak knees" He was similar to the horse you are describing. The vet didn't like it either. I will have to dig out the vet report, and post his opinions on the topic.


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## RedHorseRidge (Nov 3, 2012)

Smilie, interesting article for sure...

I'm going to ask my vet if she can do an ultrasound.

Last spring when we had her shod, we used a "navicular protocol" (the vet said to try that to see if it helped). It did for the first two months, but toward the end of the summer, she was definitely ouchy on those front feet. 

I wish I had some photos of her feet after a trim. I know her heels grow very fast and I'd like to get some feedback on the length of her toes/heels after a trim. Since she is due soon, I'll try posting some pictures and get more feedback (BTW, I used photobucket because for whatever reason, I haven't been able to post pictures directly since I joined the forum.)


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## jazzy475 (Sep 18, 2014)

RedHorseRidge said:


> I wish I had some photos of her feet after a trim. I know her heels grow very fast and I'd like to get some feedback on the length of her toes/heels after a trim. Since she is due soon, I'll try posting some pictures and get more feedback (BTW, I used photobucket because for whatever reason, I haven't been able to post pictures directly since I joined the forum.)



Make sure you look at loosie's signature on how to take good hoof pictures. Also be sure her feet are clean. You'll get better feed back if you have good pictures.:wink:


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