# Horse with Chronic Pain - Please Share Insight



## Espy (Feb 25, 2015)

Hello everyone. I made an account here a long time ago but was never very active. I think I actually talked about this same horse, and I need to talk about her again with more detail. I'm growing desperate. We just can't figure out what is wrong with her.

Esperanza is a 13 year old thoroughbred/quarter horse mare (that's her in my avatar). I've had her for 6 years. She has always had problems. In the beginning, it was just being unusually heavy on her forehand and getting very stiff and painful when she was stalled (still can't be stalled to this day). In fact, she was stalled at a show once and gave my trainer a rather nasty injury due to lashing out from the pain. We were not sure what was going on. We have a great vet and have consulted him a lot. Over time, her problems progressed and became worse. She used to be okay under-saddle without much signs of discomfort. Eventually, though, she stopped being able to be ridden due to lameness. She was doing okay for a while so we let it be, but this year things have gotten worse. Our vet began to suspect that she had some sort of stifle problem, so she had an ultrasound. Everything was normal. We started her on Previcox and that really helped a lot. She was feeling great. I was even able to do some light work with her, hoping strengthening her muscles would make her feel better. But about a month ago things took a nose dive. At first we thought it was colic. She was showing signs of pain and laying down. The weird thing was that she had this ridge on her side from shoulder to haunch like all of her abdominal muscles were tensed up. The muscles all along that part of her body were rippling weirdly. I have video of this if anyone wants to see. She stopped eating. She dropped a huge amount of weight. Our vet came and did a full ultrasounds as well as an internal ultrasound. All organs and soft tissues look normal, nothing jumped out at him. On our vet's recommendation, we started her on Omeprazole (1x a day) and Sucralfate (2x a day) because he suspected ulcers. We also started her on Methocarbamol (2x a day) for the muscle spasms. That is along with her daily Previcox. Her eating has improved, although it's nothing like it was. She used to eat everything in site. Now she will only eat alfalfa and sometimes pellets. She doesn't even eat all of the alfalfa. She has gained some weight back, though. The Methocarbamol did stop the muscle spasms. We took her off it recently and they started back up so she is back on it. She is still not feeling well. Reluctant to move around much, definitely not happy if I try to touch that side of her, standing and moving funny (have video of that too). She's better than she was a month ago, but worse than she's ever been before that.

Our vet isn't sure what is going on. He wants to do a muscle enzyme assay, so we are doing that next.

Can anyone provide any insight on my poor mare? I would appreciate anything at all. I'm really worried about her and we are doing our best to figure it out (gosh it's expensive). I've read on PSSM, but it doesn't really sound like her. She's never been "lazy" during work (actually very quick and headstrong) and doesn't have weak muscles. I've not noticed profuse sweating ever or very tight muscles other than right now. She has always eaten a low sugar diet because she gets fat. I believe we are testing for that next, though. We didn't think to do it until now because she never really exhibited those kinds of symptoms. Just a general lameness more in line with stifle issues. But with these weird muscle spams on her flank now... I don't know. It's just one flank, though. The other flank is totally fine. She is also able to loosen the muscles and tighten them voluntarily. If I stand away from her, she loosens them but if I go to touch her flank she tightens.


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## Light (Mar 4, 2012)

Hi. Horses are very expensive. 


If it was me I would consider a referral to a Veterinary Specialist and/or an Equine hospital. What was the internal ultrasound? Has your horse been scoped to check for ulcers? 


I don't know but maybe a second opinion is in order. Even if you really like your vet, it doesn't make your horse any better or give you any answers. 


This sounds like it has been going on a while and you still don't know what is wrong. I would really consider another opinion, but try for a specialist.


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## gottatrot (Jan 9, 2011)

It sounds like your vet has ruled out a few things like ulcers and internal tumors that could cause the abdominal muscle tightening. 
Just today I was discussing Vitamin E deficiency with someone on this forum. Has your vet looked into that?

My mare had the same issue with not eating, weight loss, hind end weakness. She stopped laying down and would appear very stiff if she stood around too long. She also had the ridge of muscle on her abdomen that appeared like a heave line. Yet she never coughed.

We treated her for ulcers, and my vet drew bloodwork that showed her muscle enzymes were elevated.  I tested her for PSSM1 and was considering a muscle biopsy. Her weakness was not one sided at all and EPM is not common in our area. I was extremely puzzled and my mare was getting worse.

I read about Vitamin E deficiency, started giving my mare high dose E along with magnesium and the appropriate amount of Selenium. She improved right away and now is completely normal. Usually the hind end is the most noticeable when horses have general muscle loss because those are the largest muscles in the body. But it also can affect the tongue and jaw muscles, and since horses need to eat so often having these muscles fatigue can cause a lot of weight loss. 

What I did not realize is that unless horses are eating lush, green grass every day they can become very deficient in Vitamin E. Hay, grain and even horse vitamins contain too low levels of vitamin E for some horses to stay healthy. Without vitamin E, the muscles and nerves cannot function properly.

You don't describe what type of lameness your mare had, but I'd also consider hoof issues. However, it really sounds like a muscle myopathy or neurological issue since it is affecting the horse's eating too and it doesn't seem to be ulcers. Shivers is another possibility, but would not be likely unless your horse is unusually tall (very rare in shorter horses for some reason).


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## JCnGrace (Apr 28, 2013)

I would have her tested for PSSM and HYPP.


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## Espy (Feb 25, 2015)

Lightning,
I was not present at the time of the internal ultrasound but I believe my vet went in through the rectum for it. She has not been scoped. My vet said she was exhibiting symptoms and that treating for ulcers would be fine and that we would scope if we need to.
This has been going on a while, but never to this extent. We always thought it was a stifle because of the way she moves. She always had a good quality of life and her symptoms did not seem very unusual for a horse with a stifle issue. It's only very recently (last month) that the problems became unusual and severe. Our vet has been our vet for a very long time and we do trust him. He said that he will likely be sending us off to a specialist if he becomes stumped. We still have a few tests to run, though.

gottatrot,
No, we haven't looked into vitamin E deficiency. There is definitely no lush green grass here, although none of the other horses have any symptoms. I will definitely call up my vet tomorrow and ask about that. I suppose muscle weakness in the jaw might explain why she doesn't want to eat pellets... She doesn't cough or have any respiratory symptoms. I'm a little excited that someone else has seen a ridge like this because I haven't before. It does look just like a heave line, except just on one side. I would be so relieved if that's all it was.
I guess I did skip over what type of lameness. It is a hind end lameness. It's always been really subtle, but she leans heavily on her forehand and takes short strides with her right hind. She's never liked her right stifle being touched, which is one reason we suspected that. Her lameness has always been weird. It's hard to describe. Cantering is painful for her. She often starts and then comes to a jerky stop or even stumbles a bit. We don't think it is hooves. It definitely seems like the pain is higher up than that. Funny thing is, her lameness has always been on the right. This new muscle thing in her flank is completely only on the right. Makes me wonder if the two are even related...
She is about 18 hands, although I wouldn't describe her as tall. She is very thick and heavy.
I doubt she has EPM. we don't have opossums here at all.

JCnGrace,
I will certainly ask my vet about it. She has not been tested for those.

Thank you for the replies.


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## Dreamcatcher Arabians (Nov 14, 2010)

I'd pull some tail hair and do a 5 panel genetic disease test for PSSM, GBED, MH, HYPP, HERDA and see what she comes back with.


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## gottatrot (Jan 9, 2011)

That is a very tall horse. Horses over 16.3 hands are the most likely to get Shivers. A vitamin deficiency would not affect only one side, but it could be shivers. A sign of Shivers is an inability to back up, and having the hind leg shake when lifted.
Here's an article with some more possibilities:
https://cvm.msu.edu/research/faculty-research/valberg-laboratory/information-on-shivers

Hair testing for PSSM and HYPP could be helpful. 
Here are symptoms of PSSM:
https://m.facebook.com/notes/appaloosa-appreciation-group/symptoms-of-pssm/790364554380100/

HERDA is a skin disease. GBED testing is only necessary if you plan to breed. A horse carrying the recessive gene is not affected, and horses born affected die as foals. MH would not be a subtle, progressive illness but comes on suddenly and the horse is very sick.


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## greentree (Feb 27, 2013)

She could have cancer.....

Sorry you are having to go through this with your lovely mare.


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## Espy (Feb 25, 2015)

I don't think she has shivers. She backs up okay and is fine with her hind legs being lifted, they do not shake. After reading up on it, it just doesn't sound like her.

So far, I think the closest thing suggested is PSSM. There are still some inconsistencies there, though. Regardless, I think my next step will be genetic tests. Looking around, there are places to send samples. Weirdly enough, a 5 panel test is almost the same price as just the PSSM and HYPP. Those other three disorders don't sound very necessary, so maybe I will just test for the two anyways.
And actually, I just watched a video of a horse with HYPP and it could be that too. It had the abdominal ridge and the muscle rippling, although the horse in the video looked to be even more uncomfortable than her. I think that is definitely worth testing for.

I'm not sure what kind of cancer she would have seeing as she was checked over so thoroughly internally by ultrasound.


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## Espy (Feb 25, 2015)

I apologize for the double post. I just wanted to say a few more things and ask a question. I feel that it is not HYPP anymore but will still test for it. PSSM is starting to sound more and more like it. I saw a video that looked so much like what I'm seeing.

I am going to do the tests. Is there anything I can do while I'm waiting for the results? Should I be doing something to sort of treat for PSSM in case that's what it is? I know I read about diet, not giving sugars or starches. I read that alfalfa is not good. Problem is, she only wants to eat alfalfa and I'm afraid for her weight. She won't eat grass anymore. I wish I had some more time to read about it, but I need to head off and start my day.

Thanks so much for all of the help, everyone. I'm starting to get really weirded out that my vet didn't suggest testing for these disorders... He's always been great and helped us with everything we needed, but this last month hasn't come up with much.


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## george the mule (Dec 7, 2014)

Epsy, Alfalfa won't hurt a thing. Mine all get a skinny flake (just because they like it) with their breakfast grain/supplements; they are on free-choice hay otherwise.

There has been a bunch of work done lately on equine dietary deficiencies. I don't pretend to be an expert on the subject, but the bottom line is that dried forage is not the perfect diet, as there are a bunch of trace nutrients missing, and this lack can cause all sorts of problems. I have put all of mine on a "Ration Balancing" supplement, and have been pleased with the results, plus their hay consumption has gone down.

In any event, and as others have suggested, it's time to bring in a second opinion. I would spend some time on The Internet, particularly equine health related forums, and see if you can find a specialist to give a diagnosis. Much like human medicine, it is a "Practice", and nobody has all of the answers. Alas.

Steve


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## Dreamcatcher Arabians (Nov 14, 2010)

Espy said:


> I am going to do the tests. Is there anything I can do while I'm waiting for the results? Should I be doing something to sort of treat for PSSM in case that's what it is? I know I read about diet, not giving sugars or starches. I read that alfalfa is not good. Problem is, she only wants to eat alfalfa and I'm afraid for her weight. She won't eat grass anymore. I wish I had some more time to read about it, but I need to head off and start my day.


Do you know anything about her pedigree? That can rule in and rule out certain things, if you know her ancestry. 

I would pull the 5 panel, just because it does cost almost the same as just doing a couple of tests and it doesn't take anymore hair. To me, it's peace of mind to get the negative results as well as any positives, you know what it is NOT as much as what it IS. I know that a horse without Impressive is not going to come back as carrying HYPP but I'm not going to pay for 4 separate tests when I can test all 5 for the same or less money and I'll have that negative result on paper. Alfalfa is only an issue if your horse IS HYPP and at that point you would change diet. For PSSM1, you can cut back on starches and sugars, though until I got the results back, I wouldn't do anything except take the work load off the horse. Once you send in the tail hair, if you use Animal Genetics lab, you'll get results in just a few days. Here's a link to that site, and there's an explanation about the various things they're testing for in a panel as well as which things seem to follow others. 

Polysaccharide Storage Myopathy (PSSM)


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## Espy (Feb 25, 2015)

Well I could do the 5 panel. I'll talk to the other people involved about it. I don't know anything about her pedigree except that she is (supposedly) quarter horse/thoroughbred cross. I'll keep her diet the way it is for now. She doesn't work, of course. She's too painful. I am keeping her separate from the other horses and just letting her rest.

I will do the test as soon as I can. Hopefully I will have results by next week.


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## gottatrot (Jan 9, 2011)

Most alfalfa is low in sugar/starch so is fine to feed to horses with PSSM. 

It wouldn't hurt to start feeding her some kind of oil. PSSM has odd symptoms, and they come and go so it is definitely a possibility for your mare. In particular, they need daily movement and cannot be stalled, which is something you have noticed for your mare. 

Horses normally store glycogen (sugar energy) in their muscles for fuel. PSSM horses can't use this glycogen for fuel. If PSSM horses get too much sugar/starch, it builds up in their muscles and makes them extremely sore. Their bodies rely on an alternative energy source for fuel such as fat. Often what helps these horses is feeding high amounts of fat. It wouldn't hurt to begin adding oil to her feed, starting with 1/4 cup daily and going from there (too much causes loose stool). I'd also avoid any grain products that might be high in starch and sugar until you find out if she has PSSM.


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## Espy (Feb 25, 2015)

Okay that is good about alfalfa because she really likes it.

Yeah, she definitely can't be stalled. Nearly ripped my trainers arm off last time we tried it (hasn't been stalled since). She spends 24/7 in pasture. All of our horses are in pasture as much as possible.

Shall I maybe turn her out in the arena daily? Or is longing better? How much movement should I be getting her to do? I hate to force her because she seems so painful. I read about exertional rhabdomyolysis and "tying up". Would this change in severity be considered that? I thought movement was not necessarily good if they are currently in an episode of that. Also, it does seem a little strange that she would all of a sudden get much worse and it doesn't go away. She has had the heave-line-like ridge and the muscle fasciculations for a few weeks now. Would an episode of PSSM last that long? She did not have any change in diet or anything before this happened. Other thing is that I have never noticed sweating when she is in pain. There are other things I have noticed, though. Like a wide standing stance in general and hind end lameness. Often when I would try to work her and ask for a canter, she would break into it and then come to a strange, sort of jerky stop within a couple strides. Has tried throwing me when asked to canter as well. I don't force her when she is feeling that way, of course. I haven't put a saddle on her in some time.

I will pick up some corn oil (she has liked it in the past) today and try mixing it into her pellets. Maybe she will want to eat them more. Unless you think corn oil is not the best choice. I read that it is okay and she is familiar with it.


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## beau159 (Oct 4, 2010)

Espy said:


> Esperanza is a 13 year old thoroughbred/quarter horse mare (that's her in my avatar). I've had her for 6 years. She has always had problems. In the beginning, it was just being unusually heavy on her forehand and getting *very stiff and painful when she was stalled* (still can't be stalled to this day).


I am curious on the results you will get back from the testing. This does sound like a muscle problem. 




Espy said:


> We have a great vet and have consulted him a lot. Over time, her problems progressed and became worse. She used to be okay under-saddle without much signs of discomfort. Eventually, though, she stopped being able to be *ridden due to lameness*.


Can you be more descriptive? Where did she seem to be lame?

Have you ever had her checked by a chiropractor?

Is your vet an equine lameness specialist?




Espy said:


> She was doing okay for a while so we let it be, but this year things have gotten worse. Our vet began to suspect that she had some sort of stifle problem, so she had an ultrasound. Everything was normal. We started her on Previcox and that really helped a lot.


Did your vet do an x-ray of the stifle? Or the hocks?

If not, I would suggest you do that. Very basic test and it can tell you a lot (rule in or rule out things).

Is there any "catching" of the stifle?

I've very ... _intrigued_ ... that your vet simply put your horse on Previcox. 

Previcox does not treat anything. It simply masks pain. Of course she felt better. She was taking a "pain killer"! :-?

I know that lameness can be tough to figure out what's going on. But I would really, really question your vet for putting your horse on Previcox without even doing something as simple as x-rays! (Assuming he didn't, since you didn't say.)

I would agree to take your horse for a second opinion.




Espy said:


> But about a month ago things took a nose dive. At first we thought it was colic. She was showing signs of pain and laying down.


How long has she been on Previcox?
What dosage?

While Previcox is better than bute for long-term pain management, it still isn't 100% side effect free. I've heard of horses having abdominal problems (such as ulcers) from Previcox. 



Espy said:


> On our vet's recommendation, we started her on Omeprazole (1x a day) and Sucralfate (2x a day) because he suspected ulcers. We also started her on Methocarbamol (2x a day) for the muscle spasms. That is along with her daily Previcox.


I'd have stopped the Previcox because that_ could_ be causing the problem. 

Plus, it is hard to do an accurate lameness assessment when on Previcox, because it masks pain.



Espy said:


> I'm really worried about her and we are doing our best to figure it out (gosh it's expensive).


Yup. 

I've spent thousands of dollars over the last couple years on my two horses. Lameness problems suck and they aren't cheap to figure out.

If this were my horse, as you are doing, do the muscle testing to see what those say. I would also take her OFF previcox and go get a second opinion with another lameness vet. It isn't going to hurt to have fresh eyes look at her.

May also consider checking her ovaries. Some mares can get pain there.


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## Espy (Feb 25, 2015)

> Can you be more descriptive? Where did she seem to be lame?
> 
> Have you ever had her checked by a chiropractor?
> 
> Is your vet an equine lameness specialist?


Her lameness is hind end biased, but sometimes is very hard to pin down because it seems like it's everywhere. She pins her ears when I touch her right stifle, though, which is one reason we thought it was a stifle problem.

She has seen chiropractors. No improvement.

My vet is not a lameness specialist.



> Did your vet do an x-ray of the stifle? Or the hocks?
> 
> If not, I would suggest you do that. Very basic test and it can tell you a lot (rule in or rule out things).
> 
> ...


She's had x-rays and ultrasounds and the works. She has a fused hock, but the lameness and pain really doesn't seem to be coming from the hock. There is nothing wrong with her stifles as far as can be seen on xrays and ultrasounds.

I'm quite aware that Previcox is a pain killer and does not treat anything. Problem is, despite xrays and ultrasounds and examination after examination, we a have never been able to find anything wrong. The Previcox is an attempt to improve her quality of life.



> How long has she been on Previcox?
> What dosage?
> 
> While Previcox is better than bute for long-term pain management, it still isn't 100% side effect free. I've heard of horses having abdominal problems (such as ulcers) from Previcox.


She has been on Previcox for roughly 4 months. Her dosage is 113.5 mg daily.

Our vet seemed to think ulcers are pretty rare from Previcox. We have treated fully for ulcers with not much improvement.



> I'd have stopped the Previcox because that_ could_ be causing the problem.
> 
> Plus, it is hard to do an accurate lameness assessment when on Previcox, because it masks pain.


I will consider taking her off the Previcox. That's something I need to discuss with others. I think it's unlikely the Previcox is causing the problem seeing as how she has had problems for a very long time before she started Previcox. Aside from that fact, I've never read anything about Previcox causing what she is going through. With her level of pain (which caused her to stop eating and lose weight), I'm reluctant to take her off of it.

She has had quite a few lameness exams. Once again, the Previcox is an attempt to improve her quality of life.



> Yup.
> 
> I've spent thousands of dollars over the last couple years on my two horses. Lameness problems suck and they aren't cheap to figure out.
> 
> ...


I'll consider a second opinion, but I think I'm going to wait for the results of the muscle enzyme assay and the 5 panel genetic test. Personally, I think this goes beyond lameness. Lameness is not the problem, just a symptom.

Her ovaries are fine. As I mentioned before, she had a full ultrasound (internal and external) and all of her organs are perfectly normal. No stones, masses, or enlarged structures.

The plan: Muscle enzyme assay, 5 panel genetic test, removing any sugars from her diet (which she was not getting much to start with) and adding oil. Once I have the results of the muscle and genetics tests, we will go from there. If she is diagnosed with PSSM than there we go. If she is cleared, I will likely be seeing a lameness specialist. More and more, though, I am starting to think it is likely to be PSSM. I've been reading a lot and watching a lot of videos. She is very much like the horses I read about and see in the videos.

I know this situation perhaps seems a little weird to outside eyes, but there are reasons for the things we've done and choices we've made. I'd rather not delve into that personal stuff, though.


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## Dreamcatcher Arabians (Nov 14, 2010)

Just watch the corn oil, it is an inflammatory. There are better ones you can use that don't cause an inflammatory response. Look for oils high in Omega 3s and low in Omega 6s. Honestly, I wouldn't change anything until I got the results of the DNA testing, that will hopefully point you in a more definite direction.


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## Espy (Feb 25, 2015)

What oil would you suggest?

I'm getting people saying to add oil and others saying not to, so I'm not really sure.

Unfortunately I already bought some corn oil because I read in multiple places it was okay to use and I figured she would have the highest chance of wanting to eat it over other oils.


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## SorrelHorse (Apr 9, 2009)

Can I ask where you live?

Sorry if this isn't helpful, but I live in Oregon, and I have been working with a lady who uses cannabis in horses wtih high anxiety, muscle spasms, colic, chronic pain and discomfort, etc with a lot of success. If you somewhere where it is legal, maybe that would be an option? Our clinic here has actually start prescribing it. My two ancient arthritic horses have been moving freely since they started it.


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## egrogan (Jun 1, 2011)

SorrelHorse said:


> Can I ask where you live?
> 
> Sorry if this isn't helpful, but I live in Oregon, and I have been working with a lady who uses cannabis in horses wtih high anxiety, muscle spasms, colic, chronic pain and discomfort, etc with a lot of success. If you somewhere where it is legal, maybe that would be an option? Our clinic here has actually start prescribing it. My two ancient arthritic horses have been moving freely since they started it.


This is fascinating- sounds worthy of a thread of its own. I know there have been concerns reported about recreational cannabis being ingested by dogs, but it makes a lot of sense there could be therapeutic benefits when used appropriately for animals. Would love to know more. Is your clinic involved in efficacy research? If so, would be neat if you could post some of that.


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## beau159 (Oct 4, 2010)

Espy said:


> My vet is not a lameness specialist.
> 
> The Previcox is an attempt to improve her quality of life.
> 
> ...


Your horse is *young*, at age 13. She can't possibly be on Previcox the rest of her life. That's too long.

In my opinion, Previcox is only a last resort medication. If this were my horse, I would absolutely be taking them to a lameness specialist, before I decided to just give Previcox. You certainly have not yet exhausted all your options.

I primarily deal with two different lameness specialists with my horses; one is one of the best vets in the region and it's a 6-hour drive one-way to get to him. Neither of them would ever put a horse on 113.5 mg per day of Previcox. That's a "double dose" in their eyes as the normal dose is 57 mg.



Espy said:


> She's had x-rays and ultrasounds and the works. She has a fused hock, but the lameness and pain really doesn't seem to be coming from the hock. There is nothing wrong with her stifles as far as can be seen on xrays and ultrasounds.


That's good that there is no obvious problems on the x-rays .... as seen by your "non lameness" vet. I truly don't mean that to be snarky, but I do think you should get a second opinion by a lameness vet if your muscle tests do not turn up anything.

Are you able to post the x-rays here?
Is the hock COMPLETELY fused?

Has your vet done flexion testing or nerve blocking?




Espy said:


> Our vet seemed to think ulcers are pretty rare from Previcox. We have treated fully for ulcers with not much improvement.


They are rare, but _not_ impossible and they can happen. If you are going to treat for ulcers, I would have taken her off Previcox. 

A medication is a medication, and there are potential side effects. 




Espy said:


> My vet is not a lameness specialist.
> 
> 
> She has had quite a few lameness exams.


:confused_color:

By who? Your vet that you say is not a lameness specialist?
Or a different one?

Again, not meant to be snarky; just trying to understand the situation.



Espy said:


> Once I have the results of the muscle and genetics tests, we will go from there.


Of course, that's a fair assessment. 

Does your current vet have much experience dealing with muscle problems? (assuming, one of the tests come back positive)


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## SorrelHorse (Apr 9, 2009)

egrogan said:


> This is fascinating- sounds worthy of a thread of its own. I know there have been concerns reported about recreational cannabis being ingested by dogs, but it makes a lot of sense there could be therapeutic benefits when used appropriately for animals. Would love to know more. Is your clinic involved in efficacy research? If so, would be neat if you could post some of that.


So I'll be honest up front, I am not the one doing the majority of the dosing and decision making - I am more so supplying and handling the horses, and just in general being a part of the process. A good friend of mine, who is older, and has been with horses much longer than me started it - She uses an oral version (High CBD, low THC) that she either rubs on the gums or gives to a horse in a carrot.

She has been helping horses in particular with the change in the season, and she supplies me with a bag of mini stuffed carrots for my older geldings. I laugh though, because not only have they gained range of motion, they also have "munchies"...Snort....They eat and eat and eat ravenously, even though they have been given plenty of hay. 

For dogs it is my understanding that you cannot give them ANY THC....at all. Horses are different though and can tolerate it. 

This gal also has been keeping it on hand at places that have rescues, or owners with risk horses, because if they colic or something happens and the vet can't get there fast enough to put them down....The cannabis on the gums takes away the pain and eases them into passing without any thrashing or suffering.

My young mare who is a high anxiety type is also starting it, and so far it has made her extremely agreeable under saddle. Her willingness has vastly improved, and she is also now allowing me to stretch her and do body work on her without kicking (She's a violent kicker) or causing a fuss.


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## Wallaby (Jul 13, 2008)

I haven't thoroughly read this thread, but PLEASE PLEASE PLEASE get a 5-panel on your mare.
I'm concerned about PSSM1 and/or HYPP for her for a start.

If she comes back clear for those, please consider a muscle biopsy [with desmin stain] to check for PSSM2, MFM, and RER. MFM and RER are prevalent in TBs. Both MFM and RER are less common in QHs, but common enough that I know people who owned horses with both those myopathies.

If that isn't enough, a horse can multiple myopathies at once - RER and PSSM2, PSSM2 and MFM, etc 

Here's info on PSSM1 and PSSM2 - Polysaccharide Storage Myopathy (PSSM) | EquiSeq
Info on RER - https://cvm.msu.edu/research/faculty-research/valberg-laboratory/recurrent-exertional-rhabdomyolysis
Info on MFM - Myofibrillar Myopathy (MFM) | EquiSeq


My gelding has RER and it's basically like somebody mixed an anxiety disorder with a tying-up disorder. Being stressed by something, even something as small as being fed last, causes his muscles to get ready to run...except that, most of the time, he can't [and shouldn't!!] run the stress away. So that stress/calcium/adrenaline/etc sits in his muscles and causes them to stiffen up and/or spasm...which causes him extreme pain. He, of course, understands the cause and effect on some level ["I got scared and my muscles started to hurt"] which, of course, causes him to have an even higher level of anxiety the next time he's in a stressful situation. 
Unfortunately for him, he teds to have a really "chill" anxiety reaction [ie, he freezes and goes to a safe place inside his head] so, outwardly, he appears really really calm. But he's "really calm" because he's utterly terrified.
Anyway, in an extreme situation, his muscles will be rock hard, he'll be dragging his toes, and he'll have muscles spasms usually in his loin or shoulder area.
Prior to getting him on a better-for-him diet, he was consistently "sort of off." Nothing a lameness exam could really pick up, but something was definitely wrong. Now he's doing a million times better and moving a million times better!!  It's rare that he looks outright "lame" these days.
I've been able to figure out his signs of panic and he hasn't gotten really bad in the last month or so.


The unfortunate thing about RER, despite what the link I showed you appears to imply, RER really doesn't seem to be anything that fades away. My guy is going on 14 and he's a hot mess. A loveable mess, but a mess.

Here are some pictures/videos of my guy, before and after, for examples. For the record, he's a Lipizzan/Arabian cross so...keep that in mind. haha

The old photo is first - taken in July 2013. The second photo is from July 2016.










Here's a video from about 2 years ago [you don't have to watch the whole thing, it's super long]






And here's one from a few months ago, on a better diet. I started him on high-fat soon after this video and he's doing even better on that. But this video shows enough - he's moving a lot freer, not as braced against himself, generally looking like he's not about to fall over from exhaustion... haha






He's not 100% and he has good days and bad days, but, overall, he's much healthier and feeling a lot better these days!


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## Espy (Feb 25, 2015)

> Can I ask where you live?
> 
> Sorry if this isn't helpful, but I live in Oregon, and I have been working with a lady who uses cannabis in horses wtih high anxiety, muscle spasms, colic, chronic pain and discomfort, etc with a lot of success. If you somewhere where it is legal, maybe that would be an option? Our clinic here has actually start prescribing it. My two ancient arthritic horses have been moving freely since they started it.


I live in New Mexico. THC is not legal here, but CBD is. It's very expensive, though. However, I like CBD and I think it works well for a lot of individuals, so I will consider it in the future. However, right now I'm not looking for pain management. I need a diagnoses.



> Your horse is *young*, at age 13. She can't possibly be on Previcox the rest of her life. That's too long.
> 
> In my opinion, Previcox is only a last resort medication. If this were my horse, I would absolutely be taking them to a lameness specialist, before I decided to just give Previcox. You certainly have not yet exhausted all your options.
> 
> I primarily deal with two different lameness specialists with my horses; one is one of the best vets in the region and it's a 6-hour drive one-way to get to him. Neither of them would ever put a horse on 113.5 mg per day of Previcox. That's a "double dose" in their eyes as the normal dose is 57 mg.


We never planned for her to be on Previcox for her whole life. It is a temporary measure.

Again, I'm going to wait for the muscle tests to come back before worrying about the lameness.

My vet said it was okay, but I will gladly do some reading. Regardless, I have discussed it with others and we have agreed to take her off of it.

6 hours of travel is 100% out of the question for her.



> That's good that there is no obvious problems on the x-rays .... as seen by your "non lameness" vet. I truly don't mean that to be snarky, but I do think you should get a second opinion by a lameness vet if your muscle tests do not turn up anything.
> 
> Are you able to post the x-rays here?
> Is the hock COMPLETELY fused?
> ...


I can't remember if we've looked for a lameness specialist or not. I feel like we may have and had trouble finding one within a reasonable distance, but it is tough to remember exactly. I will check again once the muscle tests come back. Long travel is 100% out of the question for her.

I will call my vet and see if he can get me the xrays in a form I can post.
Yes, the hock is completely fused.

Yes, we have done both flexion tests and nerve blocks and they were normal. Nothing to note.



> They are rare, but _not_ impossible and they can happen. If you are going to treat for ulcers, I would have taken her off Previcox.
> 
> A medication is a medication, and there are potential side effects.


I think this is a good point, and perhaps we were pretty stupid about that. Regardless, we are taking her off of it now.



> By who? Your vet that you say is not a lameness specialist?
> Or a different one?
> 
> Again, not meant to be snarky; just trying to understand the situation.


Yes, our vet did do the exams. Our vet has been in practice for 30+ years. He does know some things.



> I haven't thoroughly read this thread, but PLEASE PLEASE PLEASE get a 5-panel on your mare.
> I'm concerned about PSSM1 and/or HYPP for her for a start.


Yup, we are doing it. In fact, we just collected the samples about an hour ago and they are all ready to send off tomorrow morning.

Thanks for the all the videos and stuff. She does move kind of like yours did in the beginning. Really braced and stiff and unwilling to go forward. You're description of him sounds pretty familiar, too. Hers definitely isn't triggered by anxiety, though. And I've never seen her that severe, rock hard muscles and all. This is the worst I've seen her for sure. Mostly it's muscle spasms and a certain amount of stiffness. Definitely in pain and not wanting to go forward. Her gate is a disaster. She will not have me touching her in some areas. I touched the muscles near her stifles and she really had something to say about that. On both sides. I thought initially this was one-sided, but it's actually both sides if you look for the muscle fasciculations. They are there.

We're doing the 5 panel and a muscle enzym assay. We decided that if the genetic test comes back clear, we will do a muscle biopsy for sure if the muscle enzyme assay comes back abnormal and probably even if it doesn't.

At this point I'm thinking it is very likely muscular.


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## gottatrot (Jan 9, 2011)

If you are on facebook, you might want to check out the PSSM forum on there. Just type in "PSSM Forum" and it should come up. That is where I learned a lot about PSSM when I thought my horse might have it. It has lots of information about the right diet and treatment. I believe most people say 15 minutes of walking daily can help a lot. 

There is probably information also about using Previcox to get horses through rough patches. You are correct that it is a much better choice for horses with chronic pain as compared to Bute which often causes ulcers when given regularly. It's similar to a human taking Tylenol rather than Ibuprofen daily; Ibuprofen carries a risk of stomach ulcers so if you are taking both in a normal dose, Tylenol less commonly causes adverse effects.

With muscle fasciculations on both sides, it sounds a lot like what I've read on that forum about PSSM symptoms. 

I wouldn't worry too much about the corn oil. This is not really an inflammatory process per se, even if some inflammation occurs. A better cheap choice would be canola oil, since it has Omega-3 fatty acids. However, these are things that are more likely to affect a horse over the long term in a diet, and would be splitting hairs at this point when your horse is affected severely. There are a few oils that people love due to the types of fatty acids, but many of them are either very expensive to feed in large amounts (PSSM horses need large amounts of fat) or they have a flavor some horses don't like. Both corn oil and canola oil are relatively tasteless. Once I thought I'd feed my horse olive oil but that one is hard to get horses to eat.

If your horse ends up having PSSM, you may end up needing to try getting about 2 cups of oil fed per day.
@Wallaby, what kind of fat do you feed?


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## Espy (Feb 25, 2015)

I'm not on facebook, but if she gets diagnosed I will consider making one specifically to participate in that forum. I can walk her, I just wasn't sure if that should start now or not since she is in a bad way.

I did give her a bit of corn oil. I feel like it couldn't hurt and could potentially make her feel better. I will definitely consider switching to a different oil, but I'd like to get through this jug of corn oil first.

The test samples are going out first thing in the morning, so hopefully I will have results early next week. I think now we just wait. I'll keep her diet the same for now, with 1/4 cup corn oil. Then when we get the results we can go from there on what the next step is.

Honestly, I'm feeling really excited at getting closer to an answer. It's not that I want her to have a genetic disorder with no cure, but at the same time, I would just be so happy to finally have a diagnosis and be able to move towards the path of healing instead of endless tests that always come up normal.


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## Wallaby (Jul 13, 2008)

gottatrot said:


> @*Wallaby* , what kind of fat do you feed?


I feed Cool Calories [7oz/day], rice bran oil [6oz/day], and flax seed oil [5oz/day].


I would definitely steer clear of corn oil. It's pretty much avoided by all PSSM people feeding fat, I think due to the omega ratios but I'm not 100% sure. 
I'm, personally, extremely allergic to corn so it's off the table for me too. haha 

Canola is a favorite of most "fat feeders," as is flax seed oil. Not many people seem to use rice bran oil, but I found it relatively cheaply on Amazon and my gelding is allll about rice bran so I'm not gonna win that battle! haha
Many people seem to really like cocosoya, but soy makes my gelding extremely symptomatic. So I do my best to avoid anything with soy in it.

Rice bran pellets are sometimes recommended as a fat source, but they are actually quite high in NSC for how much fat they actually provide. It's a good idea to avoid them until you know what you're dealing with - they're only gonna make P1 worse, maybe help RER, and not help MFM/P2 at all [MFM and P2 need very high levels of protein supplementation - fat doesn't help them at all].



People told me that the expense of Cool Calories would be too much to feed in significant portions, but I haven't found that to be true. And I am, by no means, rich. 
CC, as a fat source, is cheaper than flax oil, and comparable to rice bran oil. I guess, if my gelding weren't allergic to soy and I could feed cheaper oils [ie, soy oil mixes], CC would seem very very expensive! :lol:


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## gottatrot (Jan 9, 2011)

Wallaby said:


> People told me that the expense of Cool Calories would be too much to feed in significant portions, but I haven't found that to be true. And I am, by no means, rich.


Interesting. I read from several sources that you have to feed twice the volume of dry fat to equal the same volume of oil. So besides the fact that I couldn't imagine how to get 4 cups of Cool Calories into a horse, a bag cost me around $25 for 8 lb. 4 cups a day would have cost me $6.25 a day versus 2 cups of Canola oil which cost me 80 cents a day. That's $187 a month versus $24. So I can see why people would think it too expensive.


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## Dreamcatcher Arabians (Nov 14, 2010)

Espy said:


> What oil would you suggest?
> 
> I'm getting people saying to add oil and others saying not to, so I'm not really sure.
> 
> Unfortunately I already bought some corn oil because I read in multiple places it was okay to use and I figured she would have the highest chance of wanting to eat it over other oils.


Ask 10 horse people about their opinion on ANYTHING and you'll get 20 different answers...

Flaxseed oil is high in Omega 6s, as is Soy (cocosoya oil) is high and pretty palatable to most of them. I've used it on several and never had one turn up their nose.


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## Espy (Feb 25, 2015)

Well the hair samples have been sent off and we are running the muscle enzyme assay today. We are also checking her electrolyte levels.

She looks a little better to me today, so I'm going to walk her later for maybe just 5 minutes or so to see if that helps. I don't want to overdo it.


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## Espy (Feb 25, 2015)

Walked her on the longe line for about 5 minutes today at her own pace. She seemed to ease up a little bit by the end. Still not a healthy gate, but not quite so stiff and braced. She was also huffing a little bit by the end, so I think 5 minutes of walking is all she can do for now. She really wanted to go into the pasture with the other horses afterwards, so I let her. I think it's good for her mind. I just don't want her in there when everyone is eating. We have one gelding that can be a real jerk about food.

I'll keep this thread updated. Maybe it can help someone in the future.

Current regime:
2 flakes alfalfa in the morning
All day access to timothy grass
2 flakes alfalfa, 4 lbs alfalfa/grass pellets with 1/4 cup corn oil
5 minutes of walking each day

Her weight is looking better even though she doesn't even eat all of that food these days. I'm actually wondering how much of her weight loss is atrophy. Only time will tell.


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## Espy (Feb 25, 2015)

She is worse today. Maybe walking her is not such a good idea. Ugh, I need those tests to come back so badly. I don't know what to do for her.

Should I try supplementing some vitamins? Vitamin E and selenium maybe? I just hate to do nothing while waiting for these tests.


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## Yogiwick (Sep 30, 2013)

Not all stifle issues show on ultrasound but sounds like there is more going on then that.

Ulcers sounds valid. I would also look at any tick diseases if possible in your area. Another thought is severe arthritis. I would be looking at her back more then her legs/insides as far as structural issues.

Your vet sounds great and thorough but I would also be looking for a referral a this point.

I would definitely doing bloodwork and testing (diseases/vitamins) and look into supplementation, like Mg and such, some good ideas given.


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## Smilie (Oct 4, 2010)

Flax is high in Omega 3, not 6, and is recommended as a fat source for horses, as well as canola oil and fish oil, though, good luck getting horses to eat fish oil> This info is per Dr Lori Warren, an equine vet and nutritionist

From Equus Magazine, and common facts accepted by equine nutritionists, far as omega 3 to 6, and various fat sources

The ratios of these two fatty acids differ among various fat sources---many oils and foods are much higher in one type than the other. As many people know from their own nutrition, corn oil and some other vegetable oils contain a higher proportion of omega-6s, which are not as good for us because these fatty acids can contribute to inflammation and reduced cell-mediated immunity. Similarly, we know that fish contains higher levels of the omega-3s, which have many health benefits. Flaxseed and linseed oils are also rich in omega-3s. But because omega-6 and omega-3 work hand-in-hand within the horse's body, equine nutritionists place more emphasis on maintaining the proper balance or ratio between the two rather than focusing on the total quantity of either one.

What some horse owners don't realize is that pasture grasses, especially cool-season grasses like timothy or orchardgrass, have ratios of omega-6 to omega-3 that are similar to flaxseed oil. Studies from the University of Florida found that two to three cups of flaxseed oil has the same amount of omega-3 content as 22 pounds of grass hay. This means that horses on an all-pasture or hay diet would have an omega-6mega-3 ratio of approximately 0.3:1 to 0.6:1. Adding an omega-6-rich fat concentrate, such as corn oil, to that type of diet would therefore increase the ratio to about 8:1.


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## Espy (Feb 25, 2015)

I appreciate the info on omega-6mega-3 ratios. So we are saying I should switch to either flaxseed oil or canola oil? Because I can do that. However, would there be any harm in finishing off the corn oil I have? The ratio seems like it would affect a horse more long term than short term. But if there legitimately is an issue with finishing the corn oil I bought, I will buy a different oil. I just don't like to waste stuff.


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## Smilie (Oct 4, 2010)

Corn oil is high in Omega 6, thus aids any inflammation, but I have no idea as to what amount, how long,ect has ever been determined, or a clinical trial with horses done.
I just know, when I attended a lecture by Dr Lori Warren, on Omegas for horses, newest research limits oils recommended for hroses to those three (flax, canola and fish )
Sunflower oil is almost 100% omega 6, yet was fed for many years to horses, so you will have to decide on your comfort level


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## Espy (Feb 25, 2015)

Well... The lab lost our blood samples for muscle enzyme assay and electrolytes. So we'll have to have more blood drawn. Great... So annoyed.

Animal Genetics has received our hair sample as of yesterday, though, so hopefully those results will be available in a few days time.

Been playing with her diet. We are giving her less alfalfa and more timothy because she seemed to be getting worse and we're worried the alfalfa may have been causing it. She really lost interest in alfalfa pellets as well, so we've stopped giving those too. We started giving her some low starch/high fat fortified feed (Purina Wellsolve LS), a vitamin E supplement, and increased her oil intake to 1/2 cup. Stools have been looking good, so the changes in fat content don't seem to be causing any problems. I think she looks a bit better today. Her back legs were getting really stocked up because she didn't want to move, and they aren't anymore. I take this to mean she is moving voluntarily more. Structured exercise is a no go for her right now. I walked her like maybe 200 feet and she stopped and started pawing at the ground in pain and the muscle spasms increased. So she is just in 24/7 turnout with other horses during the day and by herself at feeding times.


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## Espy (Feb 25, 2015)

Still waiting for test results from both labs. Probably won't get them until next week because of Thanksgiving.

She is is looking SO much better today. She's walking around on her own a lot more and just looks much happier and relaxed. The ridge in her abdomen is much less, even when she is walking. She just looks much looser when walking and isn't standing so weirdly.

This is her feeding schedule right now:

AM:
2 big flakes grass
3 pounds Wellsolve LS

PM:
1 big flake grass
1 small slake alfalfa
3 pounds Wellsolve LS
1 pound Amplify
1/2 cup corn/canola oil mix
0.5 mg Selenium
9000 IU Vitamin E (this is going down to a maintenance dose very soon)

She's putting weight back on and just feeling much better. Her stools were getting a little loose, so we're not going to try to increase fat for a little bit. I guess I couldn't say if it is the high fat diet or the Vitamin E. Only test results will tell. The wait is tough.


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## gottatrot (Jan 9, 2011)

Interesting. Glad to hear she is doing better. Please let us know what you find out, it will hopefully help other horses in the future.

From what I've heard, most horses with PSSM that need the high fat diet also improve with exercise. It would be more consistent with vitamin E deficiency that the horse would feel worse with exercise. 

It is also true my mare with the vitamin E deficiency improved very quickly once I was giving her the E. My hope is that your problem is vitamin E rather than the PSSM, because it is so much easier to deal with from what I hear. As long as you're supplementing enough, the horse is fine. Versus PSSM which requires many interventions.
Fingers crossed!


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## Espy (Feb 25, 2015)

Well, hopefully I will know soon. I desperately want those lab results back. Of course it had to be a holiday weekend when I send them in.

I'm kind of going back and forth. I actually found your video on youtube, gottatrot, of your horse with vitamin E deficiency. A least, I am assuming it was you because your screen name is the same. I tried picking up my mare's feet like that and she did not display the same behavior. It looked like your mare had trouble putting her feet back down. Mine doesn't. I'm not saying that means my horse isn't deficient, just an observation.

I'm sort of wondering if it's actually both. The fasciculations and the ridge in the abdomen are definitely new symptoms that I've never seen in her in the 6 years I've had her. But there are other things. I found one video in particular. It was a video of a horse they were trying to ride and move forward, and the horse was swishing his tail, lurching into a canter, and then doing these little leaps before going quickly back to a trot. That's something she does. Around the time I decided she wasn't fit to ride anymore until we figure it out, she was doing just that. She would LURCH into a canter, take a stride or two, do a little leap, and then very abruptly come back to a trot. And then the time she was so painful and stiff that she attacked my trainer after being stalled overnight during a show. I know PSSM horses do especially bad if they are exercised too hard and then stalled after. The way she moves in general once the real lameness started, all braced and short and stiff. Test after test coming back normal.

I know I'm just rambling and there is no point going on about it until I get some results. It's just been so heavily on my mind this week. I've thought so long and hard about it, read so many things, and watched so many videos. Positive or negative, I just want to know. I really love this horse and if she has PSSM, I will do everything I need to to keep her healthy. She taught me to ride when she was sound. We certainly had some rough times, with a green rider on a 6 year old horse (we were lied to about her age, actually), but in the end we ended up really getting along. Even though she was young, she was a good teacher. Never purposely threw me off, but always let me know when I was doing something wrong. I became a much better rider because of her. I'm happy to take care of whatever problem she ends up having. Just need to figure out what it is...

I'll definitely keep this thread updated and as detailed as I can in the hopes someone else having a similar problem will find it useful sometime in the future.


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## Espy (Feb 25, 2015)

Worse again this morning... Moving very painfully. Tensing, flinching, and pinning her ears when I touch anywhere from abdomen to hindquarters. Abdominal ridge is back and some little muscle fasciculations. Nothing has changed at all about her routine or feeding... I don't understand why it keeps fluctuating like this. It's not really in line with PSSM or vitamin E deficiency. I'm so frustrated and discouraged...


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## gottatrot (Jan 9, 2011)

Yes, that is my mare on Youtube after a very short time of not getting enough Vitamin E (just two weeks while I was on vacation). She was much worse originally before I treated her. But you are right, it's like the hind legs shake and the horse doesn't put them down right away. They tense and flex upward. It resolves very quickly once I give her more E, within a couple of days. 

Your mare's issues are very difficult and not easy to figure out. I hope you will have more answers soon.


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## Espy (Feb 25, 2015)

Thanks, I hope so too. Will continue to update.


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## Espy (Feb 25, 2015)

Test results of all kinds are in.

Muscle enzymes and electrolytes are normal

She is clear for all genetic disorders in the 5 panel.

We are back to square one and more discouraged than ever... More tests coming back normal. I have no idea what to do at this point. I don't think it's worth doing a muscle biopsy since muscle enzymes are normal. We're going to talk to our vet and see where he thinks we should go from here.

We're thinking about having an endoscopy done to see what the inside of her gut looks like. We're also thinking about starting up pain medication again for a while. She's been in a bad way in the last two days and is getting all stocked up in the back again.


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## Light (Mar 4, 2012)

I am so sorry you did not get any definitive answers. I can only offer sympathy. I know how hard it is when you don't know what is going on.


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## Espy (Feb 25, 2015)

Thank you, lightning. I seriously just want to cry right now. I feel like we're never going to figure it out. But we have to, because she can't live like this.

We talked to our vet and decided this Saturday he will come up and do another full exam, lameness exam, all of that as well as another ultrasound, this time also checking arteries in her back and things like that. Basically just take another good look and decide which direction to take based on the findings of those exams. Muscle biopsy is still an option, but I'm not sure if that money would be better placed elsewhere since blood tests came back normal. Scoping in an option, although we are pretty sure she does have chronic ulcers (although I doubt that's all that is going on).

Today we're wrapping her legs because of the stocking up and probably going to give some sort of pain medication or ace to give her some relief for a while.

We're leaving her on the high fat low starch diet. She does well on it, no need to screw with it just because she doesn't have PSSM.

Before this mess started a little over a month ago, we had changed her shoeing. Took the shoes off the back and put corrective shoes on the front. We've decided to put her back to the way her feet were, with normal shoes on all four feet in case that is a factor in all of this (although I sort of doubt it, seeing as she was already beginning to exhibit symptoms before her feet were changed).

Wish us luck... I will keep this thread updated as I go.


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## ClearDonkey (Nov 27, 2016)

I highly suggest having a different vet come out for another exam, or possibly have both out at once? Asking the same guy to keep coming do the same exam probably won't help anything. 

My mare was put down two years ago now, the story is in this thread:
http://www.horseforum.com/horse-health/neurological-problem-horse-put-sleep-590602/
We couldn't get our normal vet out that night, and ended up with a totally different guy, but he was an absolute godsend. He brought closure to my family even though to this day, we still don't know what was wrong to my girl. You really, really should get a different vet out, or consider bringing her to a University clinic or specialist.

Also, I hate to be the person to mention this, but really watch her quality of life in the coming weeks. If she continues to get worse, sometimes you just have to accept that there is no answer. I'm really hoping for this to be something that can be diagnosed and treated, but if it's not, you'll have to make the call. I had to make the call with my mare since she was incredibly uncomfortable and a danger to herself. You and your girl will be in my thoughts.

Also, since I seen the mentioning of possibly trying marijuana extract on her, look up Charlotte's Web oil. It is a high CBD strain extract, and can be ordered online to any state except for Florida. I would expect it to get pretty pricey treating a horse, but it could be helpful.


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## Espy (Feb 25, 2015)

Right, well, let me put it this way. The reason we are doing a lameness exam with the same vet is because since this mess started we have focused a lot on the abdomen and muscles. A lameness exam hasn't been done since she started getting really bad a month ago. The reason we are having an ultrasound done is because last time we just checked organs, looked for tumors, that stuff. This time we want to look at arteries and other things we didn't look at because we're wondering about back joints and things like that.

My mom really wants to do these exams with this vet. I think it's fine. I've been keeping her up on this thread and she agrees that we should get a second opinion if these exams don't come up with a lead.

Also, we will be having a different vet do the scoping so we will also be getting an opinion from him.

I seriously don't think she can be trailered right now, so going to a University is not really an option (especially considering I would probably have to go up to colorado)

We're doing everything we can...

Believe me, I have been considering her quality of life. It's just I'm trying to take one thing at a time. You see, just in August I lost my 8 year old dog to spleen cancer and in June we lost our 15 year old gelding to an extreme case of colic. I am just going to lose my mind if I lose my mare too. We have to exhaust all of our options before I consider that. I just can't take that thought right now. To lose 3 young animals in just 6 months... It would just be terrible. I've suffered so much desperate heart break this year already.


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## Espy (Feb 25, 2015)

I mean, of course I will always make the decision that is best for her. I would never be selfish enough to force her to live this way. But I need to do everything I can before I consider that possibility. I wouldn't let my my previous heartbreaks affect my decision if it comes to that, but I hope you all can understand why that possibility is so hard for me to face right now.


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## gottatrot (Jan 9, 2011)

I really feel for you. You are doing everything you possibly can, and I hope the vets can figure something out for your horse.


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## Wallaby (Jul 13, 2008)

I'm sorry you're having a rough time! I really have been there. 

A n/n result for PSSM1 doesn't necessarily mean that a horse is clear of all myopathies. For instance, MFM [which has been found in Quarter Horses and TBs] doesn't tend to have elevated enzymes in the muscle. PSSM2 is similar in that way as well.
RER does tend to show elevated enzymes, but, honestly, it's not fool-proof.

For MFM and P2, a high quality protein source, and lots of it, is the recommended way to start. Some people have had luck with Purina SuperSport, others do that and alfalfa - it all depends on what the horse needs.

I think I mentioned the PSSM Facebook group to you? They are able to look at a horse's bloodlines and tell you what she might be at risk for. Do you know her bloodlines? If you want to PM me, I'd be happy to do that for you, and tell you what they say, if you don't want to make an FB account!


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## JCnGrace (Apr 28, 2013)

I was hoping the 5 panel would show something so that you'd know which direction to take. I'm sure it must be very frustrating not knowing what to do to help your mare. Since you don't feel like your mare could tolerate a trailer trip how about asking your vet to consult with the nearest university? I've had a couple of different vets over the years that didn't hesitate to call Purdue if something was stumping them.


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## Espy (Feb 25, 2015)

Wallaby, you bring up good points. I'm going to read what up on all the different kinds of myopathies affecting QH and TB. Perhaps a muscle biopsy would be worth it. I'll definitely talk to my vet about that when he comes up on Saturday. The blood sample was also a few days old because the lab was being really stupid, so I wonder if that could have affected the results.

I'll look into protein sources, but I don't want to go changing her diet all crazy on a hunch. She is actually gaining weight back on her low starch/high fat diet so I think we'll wait until we know more to change anything.

You did mention the PSSM facebook group. Unfortunately, I know absolutely nothing about her bloodlines. I couldn't even tell you with 100% certainty that she is an appendix. I only know what I've been told, and a lot of that was lies. I suspect she is an appendix because of her body shape and her temperament. But if you think there is anything valuable the PSSM group could do, I would of course be grateful for anything.

JCnGrace, I was hoping the 5 panel would turn up something as well. I will definitely ask my vet when he comes on Saturday about consulting with Colorado State. I know she would never be able to handle a trailer trip right now. She doesn't even want to walk some days, and gets upset with any touch. She is a pretty big horse and I feel like it would just be cruel to make her squish into a trailer in this state when she can't even tolerate a fairly large stall.

Thanks for all the support. It's been a hard road and this last month has been full of worry and frustration. My whole family, especially me since this horse is so special to me, has been having a rough time with watching her get better and get worse seemingly as random. After the recent loss our our TB gelding and our dog, I think this has been especially scary and hard for us. I'll keep this thread updated, as usual.


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## Espy (Feb 25, 2015)

Decided to post the videos I took a while ago showing the muscle fasciculations, the abdominal muscle "ridge", and her lame gates. Just for information's sake, I suppose... I still don't know exactly what I want to do. I'd like to have a muscle biopsy done, but none of these myopathies really sound like her. I just don't understand what possibly could have triggered this.


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## gottatrot (Jan 9, 2011)

When I see those videos I get a strong impression of a horse that has something very wrong with her back. You have vets, but what I see is a horse that has very sore muscles and is bracing hard to keep her back from hurting as she moves. Is it possible she has an undiagnosed fracture or nerve problem? Her legs seem to move fine. All of the muscle spasms and soreness can be from overuse of the muscles due to trying to keep her back immobilized. The abdominal muscle ridge can be from "splinting" to keep the back stable.


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## gottatrot (Jan 9, 2011)

Now I'm looking at the videos again and I see something very odd about her withers. Have the vets looked for fistula of the withers? It is inflammation that can be infectious or non-infectious, and could be giving her a very sore back, causing all the bracing and muscle problems.


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## Espy (Feb 25, 2015)

Anything is possible. We're going to have a long talk about her with our vet. She'll have a lameness exam, we're thinking about doing nerve blocks depending on what the lameness exam turns up. I have a lot of questions for my vet. I tried to look into finding some sort of specialist (muscle, lameness, whatever), but definitely didn't have any luck online. I'm going to ask our regular vet if he knows anyone. Sometimes I feel like I just live in the worst place to have horses.

I'm tempted to suspect her back too, but there are inconsistencies. I'm noticing that if I run my hand along her hamstrings she flinches. She flinches when the touch her stifles. She flinches when I touch anything mid-section to hindquarters, basically. I'm not totally sure I understand how those parts have much to do with bracing the back. I could definitely see the abdominal muscle thing being bracing the back, especially with its asymmetry. Not sure about stifles and hamstrings, though. To me, it seems almost like her skin is sensitive. I don't need to use any pressure at all to get a reaction.

As for her withers, she has scarring on her withers. For whatever reason, the scars look really prominent in the videos. In reality, she has scars but they're not that intense. Just a sort of raised area where there is not much hair growth. I can take pictures of her withers for a more accurate look. I didn't mention it because I didn't really think it was relevant. A couple years ago she had an accident in the trailer that caused a lot of surface damage to her withers. She recovered well, but she does have some scarring. I fretted over the scars and possible damage and had her examined and I have also done everything I could think of to get a pain reaction from her regarding her withers but never got a response. Her lameness issues started long before the trailer accident, and this more severe problem we have been having started several years after the trailer accident. Whatever the problem is, I'm 99% sure it is farther back on her body than her withers. I can put as much pressure as I want on her withers, but anything mid-section to hindquarters she isn't fond of me touching.


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## Light (Mar 4, 2012)

Hi;
Check out the following site. It may have some useful information for you. I don't think I have posted this before. If I did earlier.....oops. 


UC Davis provides veterinarians with resources for EPM


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## Horsnaround64 (Dec 31, 2011)

Not sure if this has been mentioned But what about Lyme. It can do so many different things to a horse. And hard to diagnosis


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## phantomhorse13 (Feb 18, 2011)

Espy said:


> I'm tempted to suspect her back too, but there are inconsistencies. I'm noticing that if I run my hand along her hamstrings she flinches. She flinches when the touch her stifles. She flinches when I touch anything mid-section to hindquarters, basically. I'm not totally sure I understand how those parts have much to do with bracing the back.
> 
> A couple years ago she had an accident in the trailer that caused a lot of surface damage to her withers.


As a human who has issues with back pain/spasms, I can tell you that sometimes the spasms can cause pain and/or tingling and numbness in places that don't seem to have any relation to my back. For example, when a certain set of muscles in my back get tight, the symptoms show as pain and/or numbness in the top of my left foot! The very first time it happened, the doctor (understandably) spent a bunch of time testing my foot and ankle, and all of those came back normal. It wasn't until I happened to go in for my regular chiro appt that we figured out the issue. Other times, I can have dull, aching or sharp, shooting pain in seemingly random places (generally my legs but sometimes radiating up into my shoulders).

That knowledge, along with your comment about a trailer accident involving her withers makes me wonder just what is going on in her spine. It's entirely possible what seemed like only surface trauma actually went much deeper. My mare was also involved in a trailer accident and at first seemed to have come out of it with only minor surface injuries. However, with the passing of the years, I came to realize she traumatized some cervical vertebrae in the accident - and it took a long, convoluted route to figure that out, so I sympathize with your current struggle to help your mare immensely. I am not sure if trying to take x-rays of your mare's withers/spine is something possible in the field, but it might be very telling.




Horsnaround64 said:


> Not sure if this has been mentioned But what about Lyme. It can do so many different things to a horse. And hard to diagnosis


I would second this too, simply as a rule-out. I don't think the OP's area is a hot bed for ticks like some other places, but its one more thing to check off the list.


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## ClearDonkey (Nov 27, 2016)

phantomhorse13 said:


> That knowledge, along with your comment about a trailer accident involving her withers makes me wonder just what is going on in her spine. It's entirely possible what seemed like only surface trauma actually went much deeper. My mare was also involved in a trailer accident and at first seemed to have come out of it with only minor surface injuries. However, with the passing of the years, I came to realize she traumatized some cervical vertebrae in the accident - and it took a long, convoluted route to figure that out, so I sympathize with your current struggle to help your mare immensely. I am not sure if trying to take x-rays of your mare's withers/spine is something possible in the field, but it might be very telling.


I second what was said above. A week before my mare was put to sleep, she bucked one of my friends off, HARD. I don't know if she could have injured herself enough to show what drastic symptoms she had a week later, but that is the only possible lead we had as to what happened. Spinal injuries are not something to wait around on, as soon as we noticed her symptoms, and emergency vet was called, she was evaluated, and put to rest. To this day, if anyone asks what happened, I just say it was likely a pinched nerve. I really, really hope you find answers for her, and for you.


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## Espy (Feb 25, 2015)

Thanks, lightning, for the link. I'll check it out.

Horsnaround64, we've thought about lyme, and it's possible. It's just very rare here.

Well, I just want to mention again that these issues were present for years before her trailer accident. It didn't get worse after the accident, and this latest weirdness has occurred years after the accident. She had changed owners several times before she was 6 years old before she came to us, I'm guessing because she has always had problems. I would love to xray her spine, but our vet said we would have to take her to a university for that. We don't really think it's a nerve or neurological issues because she doesn't have trouble moving. No toe dragging or inability to move her legs. She CAN do anything, she just doesn't really want to. Although today she seemed like she was feeling pretty good. Trotted all by herself for the first time in probably a month.

Vet came up and did a lameness exam. We've gone full circle back to stifles. She has some asymmetrical musculature in her hindquarters with the left side being more atrophied. The sacroiliac joint is also suspect, or maybe both. I guess our next step is having both of her stifles injected and see if that helps. Our vet thinks she can tolerate a trailer trip so we're going to bring her down to have that done tomorrow morning. I'm really debating on asking if we either inject both the SI join and the stifles or maybe do the SI first. I feel like the SI joint could be more likely, but the stifles too... I don't know. Any opinions on this?

What's weird is that we suspected stifles before, but it was always the right one. The atrophy and her worse side is now the left side.

We think the abdominal muscles being tensed like that are ulcers. We can't really find another explanation and this is a very new symptom compared to the chronic ones. That symptom has been a lot less lately and she is eating much better than before. We don't think they're totally gone, so going to do another round of omeprazole.

At this point I don't really know. Our vet thinks a lot of the weird stuff we're picking up on (like how she flinches when I mess with her hamstrings) is referred pain from standing and moving weird to take the pressure off of her stifles. We didn't see anything wrong in xray or ultrasound, so perhaps injecting the stifles will be telling.

I asked about lyme disease, but he thought it was unlikely because it is rare here and there would likely be fever, joint swelling, things like that. I also thought the symptoms didn't match, but I may try to rule it out. It's just that I've never even seen a tick in my whole life here.

I asked about other kinds of myopathies and he didn't think it to be likely because of her being so asymmetrical in her pain and whatnot. I'm inclined to agree. None of the myopathies I've read on sound like her.


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## Espy (Feb 25, 2015)

We took her down very successfully. We ran a thermal scanner over her and found that she does have a good amount of heat in her left stifle, and also a bit in her right. Her back and SI region looked normal. Also had some heat near the hamstrings again more so on the left, we're guessing from referred pain.

We decided to just inject the left stifle with Depo-Medrol as a sort of diagnostic. So we'll see the results of that in the next week. The plan is to do another lameness exam when the injection has been working fully and determine if that helped at all and how much. Then we can inject the other one if necessary or move in another direction if it's not helping.

Her ulcer symptoms have been much better and that abdominal thing is pretty much undetectable. I think she did have some pretty severe ulcers from the stress of pain and maybe they are not totally gone yet. She's walking better, not stocked up in the back anymore, eating much better. I think she just confused the crap out of us demonstrating such a range of symptoms. We thought they must be one thing but in truth maybe they are two or more problems.

I get the feeling that many on this forum don't agree with some of our decisions or think we're not doing enough. We're doing all we can, and I'm not making excuses. I don't think the trailer accident is relevant. It changed nothing from before or after it happened. She has always had problems. The asymmetry in the hindquarters is pretty telling along with the thermal scanner. She's had xrays, ultrasounds, lameness exams, flexion tests. Everything looks normal except she is lame. We're pretty positive at this point that it is stifle pain, we just don't know what's causing it. Hopefully the injection will give us a clue.


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## gottatrot (Jan 9, 2011)

Espy said:


> I think she just confused the crap out of us demonstrating such a range of symptoms. We thought they must be one thing but in truth maybe they are two or more problems.
> 
> *I get the feeling that many on this forum don't agree with some of our decisions or think we're not doing enough*. We're doing all we can, and I'm not making excuses. I don't think the trailer accident is relevant. It changed nothing from before or after it happened. She has always had problems. The asymmetry in the hindquarters is pretty telling along with the thermal scanner. She's had xrays, ultrasounds, lameness exams, flexion tests. Everything looks normal except she is lame. We're pretty positive at this point that it is stifle pain, we just don't know what's causing it. Hopefully the injection will give us a clue.


I for one agree with your decisions and think you're doing everything you can! It can be so difficult with horses, trying to figure out what is going on since they can't tell us where it hurts and also often try hiding unsoundness. It was interesting to read about the trailer accident, and it explains why her withers look different. Only you know the full story and the history, so you're the best one to judge what is going on, along with your vets. For example, if my mare came up unsound, people might look at photos of her and see that her knees look odd. She has scar tissue from an old accident, but it does not make her unsound. Since I know her history, I know that a new issue would not be related, even though her knees look like they might cause problems. 

Personally, I bring up possibilities in case it might help introduce something that hasn't been thought of. Definitely take it or discard it, you know what is best.

Your vet's reasoning sounds logical and what you're doing makes sense. I agree that a muscle myopathy is not going to be one sided and neither is a vitamin or mineral deficiency. I hope you will finally figure out what is going on and can hopefully help your mare.


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## Espy (Feb 25, 2015)

I do very much appreciate all the help from everyone! And I do appreciate all the ideas thrown at me. I wouldn't have thought of a lot of things that were suggested, and I think it's good that we were able to rule so many things out. You're right that it's ridiculously hard to find where the pain is coming from in horses. We went all over the place in the last month only to land right back on stifles. And she certainly does brace her gate in a way that makes it really hard to figure out where she is lame. I think maybe the ulcers contributed to how she was moving in the videos I posted. Now that the ulcers are under control, maybe I will take another video. She's moving more normally now. I'll have to see, though. If she is sore from the injection at all, I don't want to make her do anything. 

I'm just so relieved she seems to be past the worst of it. My family and I were starting to seriously worry that we would lose her. We're wondering if she is somehow prone to stifle injuries, or has some sort of structural problem that can cause pain when exacerbated. She seems to have a chronic low-grade issue with the right stifle, maybe from an old injury, and we're wondering if this latest problem with the left stifle is a fresh injury. When it started to get cold, she started acting crazy, galloping full speed around the property and bucking like crazy. I didn't think much of it because that's what she always does when winter starts, but now we're wondering if she may have fallen and injured her left stifle. She's really not a very graceful horse and I've seen her fall before. And then the severe pain from whatever she did to her stifle caused severe ulcers that made her quit eating. Maybe one thing led to another and she ended up hurting all over from referred pain. It's just a theory, but it's the best we have right now.

We decided to wait on doing another round of omeprazole. Her low starch/high fat diet seems to be really helping to control the ulcers (happy accident! No PSSM, but the diet is still useful) and she just looks a lot more like herself. We have it on hand, though, to use if the ulcers decide to make a reappearance.

I just can't wait to see if the steroid injection helps her feel better. We have the ulcers under control, so now we can really start looking at each stifle and try to find something that makes her more comfortable. I'll keep updating with progress and whatnot, and I hope to keep getting tips and advise on what we can do better or other stuff we can try. In any case, I'm thinking of retiring her from arena work for good. If she ever becomes sound again, I think we may work on trails instead. That way she is not asked to do any little circles or jump over anything. She can move more how she is comfortable and we can do easy trails and go easy on her so as not to exacerbate the problem. I think it's good for her to exercise when she can so she can build muscle around the bothersome areas. When she was on the Previcox, I was riding her a bit over the summer and I do think it helped. She was progressively more sound until the weather sort of prevented me from riding and we went back to square one (and farther back, with this whole mess).


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## Espy (Feb 25, 2015)

I think the injection is working! I thought 2 days was a really short amount of time, but there is a noticeable difference. I can touch her stifle and hamstrings without so much as an ear flick where before she would jump out of her skin. She is standing symmetrically now so she looks more symmetrical as far as pelvis tilt goes when viewed from behind. She's standing more like a normal horse. Going to wait at least a full week if not longer to do a lameness exam, though, to make sure the steroids have the time to reach their peak affect.

Unfortunately she is tensing her abdomen again and doing the muscle fasciculations (which I am positive now are from bracing and not from some sort of nerve or muscle problem). I found out my mom had been feeding her alfalfa pellets at night, so I think that might be the culprit. We're thinking ulcers again, so think we'll go ahead and do a round of omeprazole and of sucralfate. We think it's more likely hind gut ulcers than stomach because of where her pain seems to centralize and because she is still eating extremely well despite the pain.

This has made things much clearer, though. Now we are positive we are dealing with at least two problems that are not related. A stifle issue (specifically inter-joint issue since the joint injection is working) and probably severe ulcers.

I think we're close to finally figuring this thing out.


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## CHIRO4HORSES (Dec 6, 2016)

*Horse with Chronic Pain*

Hello there might be issues with the spine. Often problems with the back can lead to the problems you are describing. If there are no physical issues with the joints then the problem is elsewhere. Chiropractic adjustments could help in this matter. Specifically a technique called VOM, veterinary orthopedic manipulation, could help to clear up some of the problems you are experiencing.


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## Espy (Feb 25, 2015)

Good news! She is amazing! 1 week after the injection and a few days on the ulcer meds, and she is sound! We did a lameness exam and her gait is normal. Now we are rehabbing. 10-15 minutes of hand walking each day for a while. She was her old self again today and wanted to go. I know she wanted to run in the ring, but we thought it better not to let her stress herself. Just easy exercise for a while to build up all the muscle she has lost.


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## Espy (Feb 25, 2015)

Okay.. Stifle pain under control but we are still battling the ulcers. It's the strangest thing, really. If she gets even just a few bites of alfalfa pellets, she gets 100x worse. We're trying to prevent that, but a somebody keeps accidentally leaving them where she can get them.

I feel like these ulcers should be under control. Does anyone have any suggestions for me to get them under control for good? Obviously, she needs a special diet at least for a while. But what am I missing? Is there a different medication you guys have had success with, supplement, feeding regime, etc?


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## 3Horses2DogsandaCat (Apr 19, 2016)

As far as I know omeprazole is the most effective ulcer medication, along with keeping hay in front of her as much as possible. Her reaction to alfalfa is interesting because many people feed alfalfa pellets to help horses with ulcers, but I have a horse who somewhat reminds me of yours (with confusing symptoms) and he does terribly on alfalfa pellets.


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## Espy (Feb 25, 2015)

Hi, I'm back in hopes of any more advice.

We are definitely past the ulcer stuff, she has gained all her weight back and is eating everything we put in front of her. We're feel like the ulcers must have been caused by the Previcox, so we will not be giving her any more NSAIDs.

The thing is, we are still struggling with her. Both of her stifles have been injected now and they helped a bit, but definitely not totally. We're positive that the problem is the stifles and nothing else. We gave her some bute the other day (one dose shouldn't be a big deal) so that she could have her feet trimmed. In the past this has been pretty intolerable for her, but she was totally fine with the bute and even cantered a few strides when we let her back into the pasture. We're really sure that it's stifle pain and not any sort of myopathy or anything.

I just don't know what else to do for her. That ulcer episode she had was really horrible and I would never put her through that again. She can't be on pain meds. If anyone has any suggestions, I would love to hear them. I'm going to PM the person that suggested cannabis since I'm not sure that discussion is allowed on this forum because using it would be illegal here. If anyone has anything else, I would be grateful.


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## JCnGrace (Apr 28, 2013)

You could try a herbal anti inflammatory/pain relief to see if it helped. I tried DC-Y for my mare with low ringbone with a lot of success. That was after having her on bute with no improvement. I feel like the DC-Y is a bit better than Bute-less. I ended up putting my old guy on it just for general old age stiffness and it helped him to move around a bit easier. 

I always ordered mine from United Vet because they don't charge a weight fee for MVP products but Valley Vet carries too.


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## Light (Mar 4, 2012)

Hi, I know that with my horse who has older arthritic stifles the more she moves the better. I mean you have to build up to it gradually. Just start with some short flat walks daily or better yet two or three times a day. By short I mean 5 or 10 minutes to start. After a week add a few more minutes onto the time and do that for a week. Then if okay add some more time. Try to avoid the energetic bursts that horses will do and try to keep everything on the flat and at a walk to start. 

With my horse I started with 5 minute walks four times a day and after a year was able to do four one hour rides a day. Of course it took a year to build up to that. She was much happier and healthier with the movement. 

Of course my horse wound up with dental issues and then really bad colic. So she has had several months off and now once again we are starting out with short hand walks and brief rides on the flat for only about 15 minutes at a time, but I am hopeful. 

My horse wound up with ulcers and they suspect it was caused by the Previcox she had been on. 

Ulcer guard and Gastro guard are the only two drugs that helped with the ulcers. 

I would check with your Vet to see if you can start some slow easy daily walking. 

If this is already what you are doing, I apologize, I didn't read all the posts. 

I admire your dedication to your sweet horse.


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## natisha (Jan 11, 2011)

There is a topical cream called Surpass which could help with stifles. Needs a prescription, at least it did a few years ago.


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## Phura (Dec 4, 2012)

Espy said:


> I apologize for the double post. I just wanted to say a few more things and ask a question. I feel that it is not HYPP anymore but will still test for it. PSSM is starting to sound more and more like it. I saw a video that looked so much like what I'm seeing.
> 
> I am going to do the tests. Is there anything I can do while I'm waiting for the results? Should I be doing something to sort of treat for PSSM in case that's what it is? I know I read about diet, not giving sugars or starches. I read that alfalfa is not good. Problem is, she only wants to eat alfalfa and I'm afraid for her weight. She won't eat grass anymore. I wish I had some more time to read about it, but I need to head off and start my day.
> 
> Thanks so much for all of the help, everyone. I'm starting to get really weirded out that my vet didn't suggest testing for these disorders... He's always been great and helped us with everything we needed, but this last month hasn't come up with much.


PSSM would be my first thought too. Not to say she didn't have an ulcer issue too. That's common for horses with pain issues, especially if there's a chronic issue like the stifle. I have dealt with ulcers before and they are very painful to the horse. Gastroguard/ulcerguard I have found are the best treatment.


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## Espy (Feb 25, 2015)

Okay, I think I'm going to try the DY-C. I'll order some very soon here.

As for keeping her moving, I don't think its a good idea. She always seems worse when I make her move, and that's always been the case, really.

She doesn't have PSSM, she was tested. We treated the ulcers with omperazole and they are gone now. She eats everything, as much as we will give her now and is not acting in pain anymore (except for the stifles).


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## Yogiwick (Sep 30, 2013)

JCnGrace said:


> You could try a herbal anti inflammatory/pain relief to see if it helped. I tried DC-Y for my mare with low ringbone with a lot of success. That was after having her on bute with no improvement. I feel like the DC-Y is a bit better than Bute-less. I ended up putting my old guy on it just for general old age stiffness and it helped him to move around a bit easier.
> 
> I always ordered mine from United Vet because they don't charge a weight fee for MVP products but Valley Vet carries too.


This, there are a million herbal things. My old mare was on straight Devil's Claw and Yucca (not a packaged supplement) but she wouldn't eat it (separate issue, I think most horses would lol).

Yes while Previcox is much lower key than bute many people seem to think there are NO side effects...not true, same side effects just not as obvious. Some sensitive horses just can't even handle that.

If you're positive it's stifles then I guess that's that. Keep in mind steroids have general effects as well so if you inject her and she's GREAT for a bit then goes back to "better but just ok" it really may be worth considering something else. But I would just treat her for arthritis (if that's the problem, sorry for not rereading the thread) and for stifles there are exercises you can do as well that are low key but may help her.

Surpass is an interesting thought, it's a topical NSAID, but I don't know if it's ok for long term use. I note this link does not say stifles but don't see why not...pretty sure I've put it on stifles before? https://www.drugs.com/pro/surpass-cream.html

For the ulcers I would put her on something like aloe long term. It's cheap and will help her stomach then if you need to you can do ulcergard for flare ups. Oh, and when you DO give bute I would absolutely give her some Ulcergard at those times.

There are many types of PSSM. What did you test for?

What do you do when you say "she's worse when she moves" and what are you doing to keep her from getting worse, is she just locked in a stall? *Regular and gentle* movement is very important. Arthritis is one of the few conditions where "bute and ride" is so important, not saying that's what you should do just that it's that important. It would be normal if she's locked up to be sore after moving around. If she can't stroll around a pasture comfortably I'd be concerned.


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## Espy (Feb 25, 2015)

> This, there are a million herbal things. My old mare was on straight Devil's Claw and Yucca (not a packaged supplement) but she wouldn't eat it (separate issue, I think most horses would lol).


We are definitely going to pick up some herbal stuff. Fortunately, she is doing fantastic right now. The ridge on her abdomen is basically gone now (which we determined is bracing from the stifle, not ulcers), she is cantering on her own, seems really happy. I opened the pasture gate this morning to get everyone separated into their normal groups and she came cantering through the gate from across the pasture and right into the barn, no problem. We are just trying to recover from a money issue, but are planning on picking up some herbal stuff soon.



> Yes while Previcox is much lower key than bute many people seem to think there are NO side effects...not true, same side effects just not as obvious. Some sensitive horses just can't even handle that.


Yeah, no way is she getting any more Previcox. I've never seen her so sick. It seemed like a really safe option, but turns out it wasn't.



> If you're positive it's stifles then I guess that's that. Keep in mind steroids have general effects as well so if you inject her and she's GREAT for a bit then goes back to "better but just ok" it really may be worth considering something else. But I would just treat her for arthritis (if that's the problem, sorry for not rereading the thread) and for stifles there are exercises you can do as well that are low key but may help her.


We are pretty positive it's stifles. My vet saw inflammation of the cartilage in one of them (the one we hadn't injected yet). She's reluctant to pick up her hind feet when she walks (But again, not right now. She is doing awesome, really picking up her feet). We're not really sure it's arthritis. It really could be, but our vet seems to lean more towards soft tissue/cartilage damage.



> Surpass is an interesting thought, it's a topical NSAID, but I don't know if it's ok for long term use. I note this link does not say stifles but don't see why not...pretty sure I've put it on stifles before? https://www.drugs.com/pro/surpass-cream.html


I'll look into this. Definitely want to be careful with NSAIDs from now on.



> For the ulcers I would put her on something like aloe long term. It's cheap and will help her stomach then if you need to you can do ulcergard for flare ups. Oh, and when you DO give bute I would absolutely give her some Ulcergard at those times.


Okay, yeah, we'll definitely pick up some aloe and some Ulcergard for her.



> There are many types of PSSM. What did you test for?


We tested for PSSM1, just a genetic test. We decided against testing for other types because myopathy just doesn't really fit her symptoms. I've thought about it a lot. She's never had an episode of tying up. her muscles have never been hard, she's never sweated excessively, she's never had any sort of muscle spasms aside from the fasciculations that ended up being due to bracing because of severe pain. I just really don't think that's what it is, and neither does our vet. Her muscle enzyme assay came back completely normal as well.



> What do you do when you say "she's worse when she moves" and what are you doing to keep her from getting worse, is she just locked in a stall? *Regular and gentle* movement is very important. Arthritis is one of the few conditions where "bute and ride" is so important, not saying that's what you should do just that it's that important. It would be normal if she's locked up to be sore after moving around. If she can't stroll around a pasture comfortably I'd be concerned.


She is NEVER stalled. She hasn't been stalled in several years for even an hour. She is 24/7 pasture. She can't be stalled, she ends up really painful. I know I've told this story many times in this thread, but once she was stalled during a show and attacked my trainer who was removing her wraps because she was so miserable. To keep her from getting worse, I just leave her alone. When I need to move her, I walk at her pace and don't make her spin on her hind end to turn around or anything. We feed her separate from other horses so she is never chased. Basically, she moves when, where and how fast she wants to move and we try to give her that freedom because forcing her to do things seems to make her worse.

As far as what I was doing that I thought made her worse, I was just hand walking her on my vet's instructions. She was doing really well with it after the injection, but once she started to go downhill again walking really seemed to hurt her. We'd walk in mostly straight lines or very large circles (around the arena) for around 10 minutes. I kept walking her when I noticed her going downhill after the injection, but she reached the point where she just didn't want to go. I cut that walk in half (so just 5 minutes at her pace) and the next morning she was not doing well. So I just stopped after that and she improved to a reasonable level and then randomly started doing awesome.

On her very bad days, she would just stop and not move and sometimes paw at the ground. She hasn't had a day like that since her injection, though. She's had ups and downs, but over all she has been pasture sound. She's definitely had days where she couldn't comfortably walk around the pasture. But she can right now. She trotts around and everything. She walks around a lot on her own now, as well. She's been well enough to where I feel comfortable letting her mingle with the geldings (she has a pony mare for company all the time), so they get let loose with her. They get to wander the whole property and I frequently see them all trotting back to the barn area from across the property.

Riding/structured exercise has basically always made her worse. She's never been sound, even when she was 6 years old she had problems. They just got worse as she got older. One reason we feel reluctant to call it arthritis is the sudden appearance of problems in the left stifle. Since we got her at 6, she always had a low-grade problem with the right stifle. But at the same time the ulcers started, she gained serious problems with the left stifle, which she never had problems with before. Arthritis doesn't usually just appear very suddenly. We have no choice but to assume she injured herself somehow quite badly and got the ulcers from the Previcox + the stress of being injured. That's really the best guess we have to fathom this very baffling mystery.


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## Yogiwick (Sep 30, 2013)

As far as I know it's the ingestion of NSAIDs into the stomach that causes stomach issues. Topical should have no effect whatsoever. You need to get it from the vet anyways, so good to ask.

Another thought is SI (if that hasn't already been covered). I find it odd that she would have soft tissue damage on both... do you have a conformation pic? The hard part with stifles is there just aren't conclusive tests.

Talk to @Wallaby about the PSSM she has first hand experience with a very involved atypical case.

I find it odd that she is worse when stalled but also worse when ridden, period. Being in THAT much pain from a soft tissue injury is odd too. Hmm... I need to go back and reread this thread!


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## Espy (Feb 25, 2015)

We've thought about SI, but she doesn't really present that way. We've done pressure and flexion and lameness tests, and it always seems to come to stifles. The SI region never shows a reaction. I don't have a comformation picture at the moment, but I can certainly get one. Either tomorrow or on Friday I could get one. There are some videos of her moving when she was pretty bad, and videos of the heave-line like things and fasciculations earlier in this thread.

I feel like the PSSM thing has been beaten to death. I think Wallaby even posted in this thread somewhere? But it might be worth another look.

She is definitely a very odd case. If you do happen to re-read the thread, I'd be happy to listen to any more input. I'm stumped, we're pretty much down to pain management. I'm very grateful she is doing better right now, though.

About being stalled, we haven't stalled her in a very long time. So I don't know that she would still be worse. Last time we tried was years ago. We were just so shocked when she tried to rip my trainers arm off after being stalled and felt she would be better just being free. She must have been in a lot of pain to attack someone because she is normally very docile and sweet. I just can't think of what else it could be other than an injury since the left stifle became such a major problem basically over night when it had always been the right and never the left that caused problems.


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## JCnGrace (Apr 28, 2013)

Yogiwick said:


> This, there are a million herbal things.* My old mare was on straight Devil's Claw and Yucca (not a packaged supplement) but she wouldn't eat it (separate issue, I think most horses would lol).*
> 
> Yes while Previcox is much lower key than bute many people seem to think there are NO side effects...not true, same side effects just not as obvious. Some sensitive horses just can't even handle that.
> 
> ...


Tried that route first and had the same result. The DC-Y meal comes in an alfalfa base and they'd take it right out of my hand if it wasn't for the fact they always had to blow on it first and scatter it here and there. I mix it with dry oats and even my pickiest of the picky will scarf it right down but won't go near her pan if I put a biotin supplement in there.


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## Espy (Feb 25, 2015)

Here is a conformation pictures as requested. Sorry it isn't the best. I needed someone to hold her and that person was on her way out so it had to be quick. I figure it's good enough. Obviously she is not well muscled and dirty from winter.

If anyone notices that bald spot, it's from an ultrasound.


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## Espy (Feb 25, 2015)

Here is one from when she was much younger and more fit, if it's helpful.


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## carshon (Apr 7, 2015)

Does this horse have Melanomas anywhere? Not trying to freak anyone out but it is the hidden melanomas that you have to worry about. 80% of Grey horses get them


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## Espy (Feb 25, 2015)

carshon said:


> Does this horse have Melanomas anywhere? Not trying to freak anyone out but it is the hidden melanomas that you have to worry about. 80% of Grey horses get them




Yeah, she does have a melanoma on her shoulder. She's had it for a long time, it hasn't gotten any bigger, and my vet said it probably won't grow enough to kill her before she dies of age related causes.


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## Light (Mar 4, 2012)

She is very cute. I am so sorry you are going through this.


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## Espy (Feb 25, 2015)

Thanks for your sympathies. =)

It was actually very striking for me to compare those two pictures. I see her every day, so I didn't really realize how much her body condition truly changed from when I took that second picture. She looks like an old girl even though she is only 12.

We've started tentatively walking her again on our vet's recommendations. We are scared to disrupt her since she is feeling better now. So we're just going to take it really easy for now. Go very slow with moving her up in activity.


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## Espy (Feb 25, 2015)

Just wanted to do an update in case anyone is curious! She is doing great! We're still not sure what made her improve so much, but she is freely cantering all over the place and she has her old spark back. Maybe she'll never be the hunter she used to be, but I'm so happy to have my horse back as far as personality goes!

I waited for about a month and just watched her in pasture to make sure she didn't get worse again. She never did, so I've recently started riding her. I've been doing so with just a bridle and a bareback pad. I think it's good this way because we are going slow. Just mostly walking with a tiny bit of trotting mixed in. It ensures I don't trot her too much on accident because my muscles are also too weak to post without stirrups for very long. We can build our muscle together. It's also more of a challenge for me. Now that she is feeling better, she has some spook in her! It's been windy lately and she has always spooked when there is wind. I'm enjoying improving my seat by not having stirrups to use as a crutch when she spooks. Not to mention riding bareback is fun and a good bonding experience. Getting on her is funny. She's pretty tall so I don't really have a surface that just lets me throw my leg over her and get on. I have to lay my stomach on her back and then swing my leg over. Today she decided to walk away while I was in the laying on my stomach part of getting on so I got to be slung over her back like a dead dear until I could get her to stop walking and could get my leg over! Okay, sorry for the rambling and random story. I'm just so pleased to have her back.

She wants to GO. But I am cautious letting her to work very hard, so we go slow. Lots of walking, turning, going over cavalettis. I let her trot a bit, usually a big circle on one end of the ring or one long side of the ring. She wants to canter, and I take that as a good sign. She will often try to pick one up in the corner. Of course I don't let her yet.

Our vet is coming out on Monday to re-evaluate her. We also need to do teeth, worming, etc so we'll do a lameness exam and talk to him about her next steps. We ordered the herbs discussed in this thread but have held off on giving them to her. With her starting work again, I feel like it's a good idea for us to be able to see how she is handling it. If she is getting too muscle sore or if her stifles start bothering her again. Then we know to dial it back. But we have them, so once we're confident she is okay working she can go on them.

Video coming soon once I can get someone to hold the camera while I ride.


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## JCnGrace (Apr 28, 2013)

Thanks for the update Espy. Happy to hear she's doing so much better!


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## BlindHorseEnthusiast4582 (Apr 11, 2016)

Sounds great. I'm so happy you got it figured out (hopefully for good).


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## egrogan (Jun 1, 2011)

Yes, good news!!


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## Espy (Feb 25, 2015)

Update! I hope no one minds if I keep this thread updated. It's helpful to me.

She's really good on the ground. Undersaddle seems harder for her. We are doing more trotting than we were, but still not a lot. She seems to get fussy pretty fast, especially going to the right, and I don't want to push her too hard.

Video:
My riding is not the best in this video, you'll have to excuse me. She kept on trying to break into a canter (I know it doesn't really look like it, but I know her!) and I don't want her to do that, so we were kind of a mess. I'm also aware that I was holding her back a lot when I should have let her trot out. I guess I'm afraid to let her do too much. She's still pretty short on the right. Much better than she was, though.





This one is from when she was really sick for comparison:


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## gottatrot (Jan 9, 2011)

She's looking great!


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## beau159 (Oct 4, 2010)

Espy said:


> She's had x-rays and ultrasounds and the works. *She has a fused hock*, but the lameness and pain really doesn't seem to be coming from the hock. There is nothing wrong with her stifles as far as can be seen on xrays and ultrasounds.
> 
> .....
> 
> ...


I know you were not directing at me, but I've re-read the thread (after reading your exercise thread).

I sure wouldn't be reluctant to call it arthritis. After all, she's got a fused hock (which is a _form_ of arthritis).

Do you know at what age that hock was fully fused? Is it both joints (of the lower joints) that are fused? Is it the right hock?

With the inflammatory process occurring in the fused hock, it's certainly not possible for that inflammatory process to spread to the nearby stifle and cause issues.

Just a suggestion: Have you thought about injecting BOTH stifles and also BOTH hocks? I know your vet has not recommended it _(side note .... did you ever get a second opinion? I didn't read that you did)_ but coming from the barrel horse world where hind end lameness is pretty common, sometimes even if you don't really have a reason to do it, it can be something to try that can make a world of difference; especially if you are grasping at straws. 

Ultrasound has it's benefits, but the images are low quality compared to an MRI. (example: small tears can be missed on ultrasound but seen with MRI) It could tell you _exactly_ what's going on in the soft tissue of the stifle. Depending on what's wrong, you could consider PRP or IRAP treatment. 

Of course, you have to decide the best route for your horse. I don't know where you are located but there are always options to take complex cases to a University. I'm probably crazier than most but I'd haul a horse from ND to Oklahoma of Texas in a heartbeat if I knew I could get some answers.

Anyway, food for thought.


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## Espy (Feb 25, 2015)

I forgot which hock is fused. I've also forgotten the details on if it is both joints or just one. My vet knows, so I can call him and ask (and will, to provide more info). I don't often think about her hocks because they've never seemed to cause her problems. It has been fully fused since we bought her when she was 6 years old (that was almost 7 years ago), so I don't know the exact age it became fully fused, but very young.

Both stifles have been injected. We first injected the left one to see if that helped (it did!) and then a bit later we injected the right one (which also helped). And then recently just in the past couple weeks we injected them both at the same time. Neither hock has been injected. Can you even inject a fused joint? It's definitely something we can do if it would help. It's just that her hocks don't hurt and never have. Every lameness test she has ever had has pointed to stifles, never hocks.

We never got a second opinion.

MRI isn't going to work for us. It would cost 1,000s of dollars and we just don't have it right now. There is a long list of reasons, we have had a very tragic year. I would love to get her an MRI but it just isn't realistic for us at the moment. In the future I would love to get enough money together to do this, but it's just not going to happen right now.


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## Idrivetrotters (Jan 5, 2013)

She looks much better, and those stifles are no longer sucked up. I am surprised nobody mentioned those stifles being sucked up and not at least doing a working blister on them. This is when a track vet is a god send when chasing lameness. Save the MRI money, get some Thermaflex and massage those stifles daily, it's not as good as a blister, but between the massage and the heat/cooling it can really help sore stifles. MRIs are great but their expense can be hard to justify.

I would also do a back sweat and have a massage therapist come out, easiest back sweat is again Thermaflex, some garbage bags, and 2-3 coolers or blankets. Rub the thermaflex in really well, place the bags on top, then put the blankets/coolers over that. 30 mins hand grazing or longer cross ties with a hay bag while she "cooks". Slowly remove the blankets, and very slowly remove the bags, rub the back and do a tail stretch and it should help out tremendously.

Best of luck and glad she is making progress!!


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## beau159 (Oct 4, 2010)

Espy said:


> I forgot which hock is fused. I've also forgotten the details on if it is both joints or just one. My vet knows, so I can call him and ask (and will, to provide more info). I don't often think about her hocks because they've never seemed to cause her problems. *It has been fully fused since we bought her when she was 6 years old* (that was almost 7 years ago), so I don't know the exact age it became fully fused, but very young.


That _is_ extremely young. And even though they might not be a part of problem now necessarily, I guarantee they were contributory to what she had going on then, since you stated she's never been "right" since you bought her.

I bought my Red when he was 6. Didn't know it at the time, but he also had a hock that that was in the process of fusing (the "upper" of the lower joint on the right side). Took us a year to figure it out because he pretty much flexed normal so we didn't even think to x-ray (until we did). While I love my vet here, I did haul to a specialist 6 hours away for a second opinion and he said Red had some of the earliest hock changes he has seen in a horse his age. For how advanced he was, he believe Red probably had fusing changes at birth. Despite doing hock injections, Red was STILL sore, so we "supplemented" with Previcox for pain managements. (He also had a catchy stifle on the right hind, to complicate matters ..... and heel pain in both front feet.) But by the spring of his 8 year old year, his right hock (upper joint of the lower) was fully fused. It hasn't seemed to bother him since but I won't hesitate doing hock injections if he seems to need it.

So for Espy to be fully fused before age 6 when you bought her, well, that is so stinkin' early!



Espy said:


> Both stifles have been injected. We first injected the left one to see if that helped (it did!) and then a bit later we injected the right one (which also helped). And then recently just in the past couple weeks we injected them both at the same time. Neither hock has been injected. *Can you even inject a fused joint?* It's definitely something we can do if it would help. *It's just that her hocks don't hurt and never have.* Every lameness test she has ever had has pointed to stifles, never hocks.


If it is fully fused, you usually won't get a needle in it. But if she doesn't have both joint spaces fused (of the lower joint) you can at least inject one of the spaces and still gain some benefit.

Again, my Red pretty much flexed normal on his hock, despite having advanced and active fusing. I'm pretty conservative about injections myself, but for the dramatic improvement I saw in Red after doing the injections, I would never hesitate to do it again if his performance starts dropping. Remember that flexions are only one piece of the puzzle. You have to look at _all_ the information, and make a decision. 

In your case, I'd absolutely try the hock injections and see if they help ..... because what if they do? Of course, I would do them separate from the stifle injections so you can truly tell if the hock injections help or not (since you already know stifle injections help).



Espy said:


> MRI isn't going to work for us. It would cost 1,000s of dollars and we just don't have it right now. There is a long list of reasons, we have had a very tragic year. I would love to get her an MRI but it just isn't realistic for us at the moment. In the future I would love to get enough money together to do this, but it's just not going to happen right now.


MRI's are expensive; I agree. I had the option of doing one with Red for his heel pain. But since it would not change the course of his treatment and would only be for my sheer curiosity, I did not feel the need to spend the money.

I brought up MRIs because I have known people who have had horses with tiny tendon tears (for example) that were not caught with any other test (flexions, ultrasound, etc) but were easily seen with MRI. When you are to the point where you have kinda already tried most everything .... thought I'd mention it. It would really tell you exactly what that soft tissue around her stifle(s) is doing.


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## Espy (Feb 25, 2015)

Ha, yeah, I know her hock fused extremely young. The kicker is that we were lied to by someone we _thought_ we could trust (clearly wrong!) when we bought her and were told she was 12 years old. I guess you learn quickly not to trust a lot of horse people, but we were naive and just trusted the seller. It was only through digging up old records that we found the truth of her age. But, you live and you learn. She's a good horse anyways, fantastic temperament.

Anyways, yeah, I will definitely give my vet a call to talk about that fused hock and about doing the injections. We probably will wait a few weeks since the the stifle injections were done very recently. I didn't even think to worry about the hocks, I was so focused on the stifles. I'm not sure if it was a suggestion or not, but I will never put this horse back on Previcox. I can't prove that the Previcox gave her terrible ulcers, but I highly suspect it. She has NEVER been that sick (or really had symptomatic ulcers at all...). I thought we were going to lose her. She isn't getting another dose of that for as long as she lives. I know it works well in a lot of horses, but not for her.

I do wish I could afford an MRI. I am desperate for answers, but it's just not going to happen right now. She's really quite sound in pasture and hopefully a decent rehab plan will make her (somewhat) sound for light work eventually, so I don't think an MRI is an absolute necessity. It sure would be nice to know what's wrong, though.

Oh and to the poster above beau, I'll check into doing some massage stuff or getting a massage therapist out. Couldn't hurt.


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## beau159 (Oct 4, 2010)

Espy said:


> HI'm not sure if it was a suggestion or not, but I will never put this horse back on Previcox. I can't prove that the Previcox gave her terrible ulcers, but I highly suspect it. She has NEVER been that sick (or really had symptomatic ulcers at all...). I thought we were going to lose her. She isn't getting another dose of that for as long as she lives. I know it works well in a lot of horses, but not for her.


No, I was not suggesting for you to put your horse on Previcox; just mentioned that that is what we did for mine.

...If you go back on this thread..... I was the one who told you to watch out for ulcers with Previcox .... which at the time you didn't believe me...... ;-)

If you have an ulcer-prone horse, you do have to be very careful with what you give them or it can flare them up.



Espy said:


> Oh and to the poster above beau, I'll check into doing some massage stuff or getting a massage therapist out. Couldn't hurt.


Absolutely worth a try. I have not had the best personal experiences with massages for horses (didn't notice any improvement) so I probably won't ever call one out again (but again, doesn't hurt to try) but I did want to mention that there are a lot of *stretches* that you can do for the stifles, which would be very beneficial. You can have your vet show you, or the massage therapist would know too.


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## Espy (Feb 25, 2015)

Ah, sorry, I didn't remember that was you. You're right, I didn't believe you. Previcox is a COX-2 inhibitor and I just didn't think it caused ulcers. But I've thought about it a lot and read a lot and now I definitely believe it.

Would stretches be a safe option considering we don't know what's wrong? Could stretches cause a healing injury to get damaged again? I'm always just afraid of hurting her again.


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## beau159 (Oct 4, 2010)

Espy said:


> Would stretches be a safe option considering we don't know what's wrong?


Absolutely impossible to know .... because you don't know exactly what is wrong. 

If you aren't going to go for further diagnostic testing at this time (totally understand) or go get a second opinion (which you could .... but doesn't guarantee they'd find anything different .... but they might), it's going to be trial-and-error to see what helps her and what doesn't.


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## Espy (Feb 25, 2015)

Fair enough.

My current plan of action is to talk to my vet about her fused hock and see about injecting them (or just the one if the other can't be injected) in the next while. I'll also look to see if there are any equine message therapists around, and if there aren't I will look into getting the supplies myself and watching some youtube videos. I'm going to hold off on the stretching. Sounds too risky to me.

I was worried about her yesterday. She was looking like she wasn't feeling too great (this was the day after I rode her). Today she looks awesome, though, so I'm thinking she was just muscle sore. I think we have a bit of a hump to get over in that area, so I'm going to make a great effort to be more consistent with her (it can be hard to find the time as a university student). I'm going to do my best to ride her 3x a week. That would probably be 5-10 minutes of warm up at a walk, 5-10 minutes trotting and pole work, 5-10 minutes of walking for cool down. I can always adjust up or down if I think it's too much or too little.


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## Espy (Feb 25, 2015)

Well that plan went down the drain. She has descended into another episode of severe pain and muscle spasms. Not sure if it was exercise related or not, because it had been several days between being exercised last and this episode occuring. This time the muscle spasms were mostly on the right instead of the left, but there was some on the left as well. Got some banamine in her, bloodwork off the labs, and omeprazole for the ulcers I know are coming. I'm pretty convinced now that the original muscle fasciculations were not from bracing for a stifle injury or really bad ulcers. I think the stifle problems and this must be separate. Next step is to collect another hair sample and send it off to be tested for PSSM2 and MFM.


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## Espy (Feb 25, 2015)




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## 3Horses2DogsandaCat (Apr 19, 2016)

Espy said:


> Next step is to collect another hair sample and send it off to be tested for PSSM2 and MFM.



That sounds like a good plan. I haven't re-read your thread to see if you're familiar with it, but there is a PSSM group on Facebook, and they have so many videos with horses showing symptoms just like yours. Maybe you will find an answer.


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## Espy (Feb 25, 2015)

I actually looked for that facebook group after I rejoined facebook recently and I wasn't sure which one people were referring too. Could someone tell me the exact name of the group and how to find it? Or link it to me?


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## 3Horses2DogsandaCat (Apr 19, 2016)

I copied the link https://www.facebook.com/groups/202978353056065/. If that doesn't work for some reason, it is just called PSSM forum. I thought my horse had it, but he was negative for PSSM 1. He ended up testing positive for EPM and is being treated for that right now. I have stayed on the PSSM group because they post a lot of information about nutrition and other things.


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## Espy (Feb 25, 2015)

Thanks! Wow, that group is awesome. I know exactly what I need to do now. I'm going to pick up all of the things they recommended tomorrow and start loading her up with it. I hope it helps. I'll keep this thread updated with what I'm doing and if it's working.


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## Espy (Feb 25, 2015)

I hope no one minds. I have to rant. I am so overwhelmed. I've had a stress headache for 3 days straight and I can't stop crying. I have university finals coming up and this mare is taking up every ounce of energy and concentration that exists in my being. I literally stand outside with her and just cry. I'm scrambling to do what I can for her but oh my god. When she gets really bad it is just the most emotionally distressing thing in the world. She just stands there and spasms and groans and paws as the ground. Right now she is getting banamine every 12 hours because it relieves her horrible pain. I am picking up Robaxin today too. There is no doubt in my mind that this is PSSM2. It just has to be. She has every single symptom. And what a terrible disease it is. Just terrible. Dietary changes coming up: Start feeding Triple Crown 30% for the high protein and because it includes the three amino acids that are missing in plant matter. Possible Tri Amino supplement for further supply those 3 amino acids. Daily magnesium supplement. I ordered ExcelEQ (recommended by facebook group) for the natural vitamin E and that will be given daily. Possible change to hay. I need to get mine analyzed, I can't tell if it's making her worse. Guys, this is horrible. The next time I buy a horse, I will be searching deeply in their lineage for the possibility of this. I can't take it. It's destroying me. Also, this post refuses to format properly so it is just going to have to be a block of text.


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## beau159 (Oct 4, 2010)

Espy said:


> I can't take it. It's destroying me.


:hug::winetime:

Hugs and a stiff drink. Keep us posted.


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## Espy (Feb 25, 2015)

Thank you. I think I need both of those things right now. I'll keep everyone posted on how she's doing and how she's reacting to her new diet and supplements. I'm relieved to say that she is feeling better for the moment after her banamine kicked in. I just saw her drink a bunch of water, and that is always a worry for me when she starts feeling really bad. So, I can breathe a sigh of relief for the next few hours until I get the Robaxin. I have a feeling that will really help.


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## ThoroughbredBug (Jan 18, 2017)

Subbing - nothing much to add unfortunately  So sorry to hear about your struggle and your poor mares condition!


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## JCnGrace (Apr 28, 2013)

Espy said:


> I hope no one minds. I have to rant. I am so overwhelmed. I've had a stress headache for 3 days straight and I can't stop crying. I have university finals coming up and this mare is taking up every ounce of energy and concentration that exists in my being. I literally stand outside with her and just cry. I'm scrambling to do what I can for her but oh my god. When she gets really bad it is just the most emotionally distressing thing in the world. She just stands there and spasms and groans and paws as the ground. Right now she is getting banamine every 12 hours because it relieves her horrible pain. I am picking up Robaxin today too. There is no doubt in my mind that this is PSSM2. It just has to be. She has every single symptom. And what a terrible disease it is. Just terrible. Dietary changes coming up: Start feeding Triple Crown 30% for the high protein and because it includes the three amino acids that are missing in plant matter. Possible Tri Amino supplement for further supply those 3 amino acids. Daily magnesium supplement. I ordered ExcelEQ (recommended by facebook group) for the natural vitamin E and that will be given daily. Possible change to hay. I need to get mine analyzed, I can't tell if it's making her worse. Guys, this is horrible. The next time I buy a horse, I will be searching deeply in their lineage for the possibility of this. I can't take it. It's destroying me. Also, this post refuses to format properly so it is just going to have to be a block of text.


Hang in there and I'll be keeping my fingers crossed that dietary changes and supplements will bring her some relief. Hugs of comfort to you!


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## Espy (Feb 25, 2015)

Thanks for the support! This is definitely one of the hardest things I've gone through. This is the horse I learned to ride on. My first horse to jump, my first horse to show, my first horse to fall off of. It is so hard to watch her suffer. Anyways, the Robaxin seems like it really helped. Her muscles aren't so tight and hard anymore and she looks more comfortable. Less spasms, although she is still getting sort of hiccups which I assume are the diaphragm spasming. We're skipping the banamine tonight since she is looking okay on the Robaxin and she has been on banamine for longer than I like. I am soaking her alfalfa and we want to pick up some PSSM-safe pellets tomorrow. She isn't eating enough right now. She doesn't seem very interested in the Triple Crown 30%. I'm leaving it out there with nothing else so that hopefully she eats it over night. I'm not sure what I can put on it to tempt her that would be safe. But she really needs to eat it.


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## stevenson (Sep 12, 2011)

I found a list of horses that have a prevalence for PSSM and a list of some of the horses that are positive for pssm. http://shameinthehorseshowring.


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## Espy (Feb 25, 2015)

That link doesn't seem to work. I don't know anything about her pedigree anyways, if that is what you were getting at. I think she is starting to do better. I'm still waiting on a few supplements to arrive, but she has been getting a ton of protein (1.5 to 2 lb Triple Crown 30% and 10 grams of Lysine every day). She still has episodes of spasming, but it seems like the constant fasciculations and pain have gone and are only intermittent now. She also has sort of hiccup-type things that are pretty weird. I'm uploading some videos to youtube and will post them later.


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## 3Horses2DogsandaCat (Apr 19, 2016)

I'm glad she's improving!


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## Espy (Feb 25, 2015)

Intermittent spasms: 



 Diaphragm spasm: 



 NOTE: yes, I know she looks pretty crappy. She has lost a lot of muscle and she doesn't feel good. We are doing our best.


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## Espy (Feb 25, 2015)

Updated diet: 

1.5 lb TC 30 (applesauce mixed in to make it tasty)
25 g whey isolate, 10 g lysine
5 g methionine
2 g threonine
4 oz Excel Eq (~2/3 cup)
8 g magnesium oxide
Still eating alfalfa, but planning on picking up some grass so she can have both. 

Banamine and methocarbomol as needed. 

Her hair sample has been sent for testing for all the other variants of PSSM. I think she's improving a bit. Still sort of up and down, good days and bad days, but I think we're on the right track. The flies are making her muscles twitch and spasm, so she has a nice fly sheet on with a neck.


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## Espy (Feb 25, 2015)

Yesterday, I spoke to a person who is very much "in" the field of PSSM/MFM/RER. I'm going to keep it very vague and refer to this person as "they", as I don't know how much they would want me to disclose for reasons we discussed. We talked for quite a while about the 4 variants of PSSM as well as RER and I really gained a lot of knowledge, including the mechanism by which P2, P3, and P4 work. I can't disclose that information, but it really helped me understand what exactly is happening to my mare. I don't have her results yet from EquiSeq, but based on what I know now, I think she is either P3 or P4, or both. I showed this person her videos of her symptoms and they said they would be incredibly surprised if she did not have one of the variants.

Another interesting thing I learned is that there is controversy about whether or not these horses need low NSC diets. There is not really a scientific reason that P2, P3, P4, or Px horses would be bothered by sugar, yet some seem to be anyways. I always wondered about this with Esperanza because sugar never seemed to affect her. It still doesn't. Between her two attacks, we were feeding her a fair amount of Amplify, which is not low enough NSC and she was fine. Before that, she had been eating Purina Equine Senior intermittently through her life, grass hay, whatever, and there was never a relationship between that and her symptoms. Based on all this, I've eased up on worrying so much about sugar. I think it's more important for her to get enough protein to reverse the negative nitrogen balance than to worry endlessly about sugar. So she has been eating as much hay as she wants even though it isn't tested and I've been mixing senior into her TC 30 to get her to eat it. There is a tiny bit of lactose in her whey powder. So far no difference. I saw no improvement when I took all the sugars away and I see no worsening now that I've added some back.

Again, keeping this very vague, but from our conversation, I do know one thing; I probably don't have much longer left with this mare. I suppose there is a chance that she could make a miraculous recovery and live a few more happy years before deteriorating again, but based on what we talked about she is pretty advanced and pretty severe compared to many other horses and MFM (which IMO should be what all the "PSSM2" variants aside from RER should be called since it doesn't really have anything to do with glycogen). is a progressive disease, very much like a certain type of muscular dystrophy in humans. I'm doing my best to pull her out of this current attack and will fight for a while longer but I'm also starting to accept that this is deadly and it may soon be time to let her go. I'll have a better idea of how to deal with it once her results come back, but I'm not confident I'm going to get her out of this one. It's hard to come to terms with that, but it's a reality and I've fought for her in every way that I could. At this point, I don't think it's a matter of "if" I will euthanize, but "when". Soon or in a few years, hard to say. I don't believe she has any chance of having the lifespan of a normal horse. I'd love if I could give her a few more happy years in the pasture, but I don't know if I can.


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## gottatrot (Jan 9, 2011)

I'm very sorry, but it's good you've had some expert consultation.
These muscle myopathies are horrible, and it's educational to hear how they are different from each other. This research is so important. Maybe someday we'll be able to get these out of the gene pool. 

It does bother me when people have a horse with a mild PSSM version and they feel that there is no big deal, and it is easy to manage. Some of those don't see the need for the genetic testing rules in breed organizations. So many horses I've heard of are difficult or impossible to keep out of fear and pain, and I'm glad we are finding out more about these diseases. 

It also can be so frustrating if you know your horse has a muscle problem, but can't figure out what it is, and treating it like a glycogen problem isn't helping.
That happened to me when my mare had her Vitamin E problem, before I found the answer. But at the time I discovered it could have been any number of muscle myopathies with any number of causes, and you have to rule out so many things like Shivers and EPM. 

Sorting all of that out is a difficult thing, and while it's good knowing "what" the problem is, I'm sorry to hear it is one of the progressive ones that is not as manageable.


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## Smilie (Oct 4, 2010)

Dreamcatcher Arabians said:


> Ask 10 horse people about their opinion on ANYTHING and you'll get 20 different answers...
> 
> Flaxseed oil is high in Omega 6s, as is Soy (cocosoya oil) is high and pretty palatable to most of them. I've used it on several and never had one turn up their nose.


Corn oil is also high in omega 6, as is sunflower seeds
Canola oil is the only oil, besides fish oil,recommended to be fed to horses, based on the Omega ratios. Flax also has a great source of omega 3


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## Smilie (Oct 4, 2010)

Just read to the end of this thread, and see you have a diagnosis. Sorry to hear what you are dealing with, and know what it is like to see a horse you care about in pain


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## Espy (Feb 25, 2015)

Thank you for the comments. It really is so hard. I think I might have to do it very soon. I can't even look at her without crying because I know what's coming. She looks so sick. It looks like someone surgically removed the muscles of her topline. I wish there was more awareness of this in the horse world, because watching her fall apart before my eyes has been more painful than any other animal death I've experienced. We're obviously losing the fight.

I'm really having trouble deciding what the right thing to do is, though. Sometimes, she is happy. Sometimes I'll go out to the barn and she'll nicker at me and be hungry and enjoy her food. Other times she already looks half dead. I've never had to make this decision before. All of the animals I lost there was really no other choice but to euthanize. This one is my choice, and my call, and I don't know how to make it.


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## gottatrot (Jan 9, 2011)

I couldn't like the above post. Very sad. You sound very compassionate and are trying to do the best for this horse. I am sure you will make the right decision when it is time.


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## JCnGrace (Apr 28, 2013)

Hard decision to make @Espy, I know. What kind of days does she have most often? If it's bad then she's probably ready, if more days are good then you might have a little more time.


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## Espy (Feb 25, 2015)

Well, a little twist of events. I woke up this morning, dragged myself out of bed knowing what is probably coming, and went outside to feed. And there I found her looking happy and bright and waiting for food. I gave her some of her high protein feed and she CHOWED down. Ate all of it. So I gave her some more and she ate all of that too. She hasn't wanted to touch that stuff in over a week, so this was extremely encouraging to me. I've stopped feeding her alfalfa based on other people's recommendations, so I gave her an enormous pile of grass hay and she chowed down on that too.

I decided to have our vet come up and have him look at her and help me decide what to do. Maybe it would have been different if he came yesterday when she was doing bad, but today he evaluated her and said he didn't want to euthanize her. I saw some of her old self today. She was very curious, walked right up to my vet and sniffed him and tried to get into his pockets. It made me so happy to see this sort of thing from her again. There was a light in her eyes that had disappeared in the last few days.

Furthermore, I received some suggestions on the PSSM forum to try gabapentin to manage her pain while we try to recover her. My vet did some tests with running his fingers along certain parts of her body and pressing in certain areas and he decided that she has very over active responses and they trigger the spasms. He said that since the Robaxin didn't work and because of her response to his tests, he thinks gabapentin might. So we're going to try it.

Because of how well she came out of her first episode, I feel like it's worth it to fight a bit more. If I can get her pain under control until this episode is over and she keeps eating her high protein feed and getting her supplements, I feel like there is hope for her living out a few more happy and pain-free years. My vet agrees. I'm doing my best to be as logical as possible. Based on the very knowledgeable person I spoke to, I don't think she is in the end stages yet. On a good day, her gait is actually not affected at all which is an important symptom in the end stages. The person I spoke to said that horses who are not in the end stages can often be recovered. I think there is hope, with the right diet and care.

I'm not sure what caused this turn around. Maybe it was removing alfalfa. I'm feeling cautiously encouraged by this, though. I did give her 1/2 dose of banamine this morning but it has been 12 hours now and she still looks really good so I skipped her dose tonight. Minimal spasming and she is out there munching away at all the food I gave her and looks interested every time I've come in today.

Her name is Esperanza, which means hope. She is currently living up to her name!


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## Espy (Feb 25, 2015)

EquiSeq has requested a blood sample from my mare, all expenses covered. That makes me think they must have found something interesting!


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## Espy (Feb 25, 2015)

I think EquiSeq heard about my struggle with deciding to euthanize my mare or not through the PSSM facebook forum, and they have reached out and asked for a blood sample so they can test immediately rather than waiting on the hair sample, which can take a while. This is really going above and beyond in my opinion.


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## Espy (Feb 25, 2015)

I just wanted to let everyone know that Esperanza is on the road to recovery! The muscle spasms are gone, she's putting weight on, and she's much more mobile. She even picked up a brief canter the other day to avoid taking her supplements! She hasn't had any banamine at all in over 2 weeks and is eating like crazy.

Today I even felt comfortable enough to let her socialize with one of the geldings. She has been dying to be social, and she is very happy to be hanging out with him.


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## egrogan (Jun 1, 2011)

Great news! Has it been the change in diet that's helping so much?


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## Espy (Feb 25, 2015)

Honestly it's hard to say! I threw everything at her that I thought would help but didn't see any improvement for a while. We've been doing the 3 amino acids and magnesium for like 5-6 weeks, the vitamin E oil for 5 weeks, she has only been consistently eating her high protein feed (Tripe Crown 30%) for 2-3 weeks, and we changed her from alfalfa to bermuda grass hay about 2-3 weeks ago. So a lot of changes here, and it's hard for me to tell which things helped and which didn't because I don't know for sure how long it takes for diet and supplements to start helping. I imagine it's very individual.

From what I've come to understand about the disease, the high protein is probably the most important thing. I'm skeptical that the magnesium and vitamin E is really doing anything, but I am not changing a single thing until she is 100% better. Then maybe I can play with things a little to try to figure out what helps and what doesn't. Then again, I'm not totally sure I want to take that risk.

She has also been on ranitidine 2x a day for about 3 weeks now, so I think that really helped with her eating her high protein feed and getting enough protein in general to recover. She has been eating non-stop, mountains of hay each day and eating her Triple Crown every day. For whatever reason, ranitidine worked waaayyyy better than omeprazole.

Interestingly enough, I don't think she is sugar sensitive at all like many people would have you believe PSSM horses are. I have no clue what the NSC content of the grass hay I'm feeding her is, and I mix about 0.5-1 lb of Purina Equine Senior into her Triple Crown to actually get her to eat it (she doesn't really eat it otherwise) and she is improving. I spent so much time and energy trying to keep her off sugars that she wasn't really getting what she needed. I guess once I threw the low sugar idea out the window in favor of getting her to eat the stuff she needs, she started to improve.

I think MAYBE she is sensitive to alfalfa, though, maybe because of the calcium content. She did start improving shortly after switching her to grass. But I'm also not sure about that, because she has done well on alfalfa her whole life and even recovered from her first episode while eating alfalfa. But you never know, and she is doing well on the grass hay, so we are sticking to it.

The other thing I'm currently wondering about is shoeing. From what I understand about this disease, even very small things like getting a minor injury can throw them into a negative nitrogen balance. This episode started pretty shortly after we put shoes back on her after she hadn't had shoes for a while. She skipped her last shoeing appointment because we didn't think she would be able to manage it with her pain, and her feet are getting long. I'm trying to decide if I should replace her shoes or leave them off. Her hooves get really cracked without shoes, but I'm also not convinced that having shoes put on her didn't have something to do with her recent decline. At this point I'm scared to do much of anything that might send her back to death's door.

I suppose I'm just rambling now. This is just a very complicated thing.


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## Light (Mar 4, 2012)

I am so glad she is improving. 

I wouldn't put shoes on her if she were mine. I would have the current shoes pulled and have her feet trimmed but wouldn't do shoes. I would however try some boots like Easy Boot recovery or clouds to help protect her feet.


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## Espy (Feb 25, 2015)

A little update for those still following our journey here.

She's really doing well. Completely clear from spasms and is gaining weight back. The muscle wasting is still incredible but we're working on it. She's much happier now. She can interact with the other horses and has her apatite back. She's able to walk freely, although I can tell she is still sore sometimes.

Current diet + supplements:
Bermuda grass hay, free choice
2 lb Triple Crown 30% ration balancer
2-3 lb Purina Equine Senior (for taste. She will not eat triple crown by itself)
10 g lysine
5 g methionine
2 g threonine
8 g magnesium oxide
~7,500 IU vitamin E (Provided by Excel EQ)

I'm happy to say that she is definitely out of being in negative nitrogen balance. Her tail is growing like crazy, where pretty much her whole life it never grew well. I am now confident she is getting enough protein and is incorporating it into her body.

We also recently decided to test her for EPM, and it appears that she has been exposed (which apparently the majority of horses have been exposed). It's a little unclear at this point, but it appears that she may be having an autoimmune reaction to the EPM exposure. Our vet is talking to the lab, and there is a specific protocol to treat her problem, so we're getting that in order.

I think things make more sense now knowing that there is something more than MFM involved. I'm still positive she has MFM (although still waiting on those results), but her case is so much different from other horses that I really figured something else must be going on. I really hope that I will see great improvements once treatment is complete.

So all in all, I'm feeling optimistic.

In case anyone is interested, here is how much her muscles have atrophied:


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## Light (Mar 4, 2012)

I am so happy she is still improving. I admire and respect the way you have really fought for your horse. She is beautiful. The muscle loss will hopefully improve in time.


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## Espy (Feb 25, 2015)

Thanks! That means a lot to me. I am hopeful as well that she gains muscle back over time. I think I surprised myself even how hard I fought to keep this horse in this world. I didn't realize how much she meant to me until I watched her fall apart and almost lost her. I've gained a certain passion for these muscle disorders through it as well. I even got to join the team researching these disorders as a research intern.

So it has been quite a journey, and a journey that has honestly changed my life.


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## Espy (Feb 25, 2015)

She was diagnosed with EPM today. I'm having the necessary drugs shipped over night so she can start the treatment tomorrow. Unfortunately having her feet done 2 days ago set her off spasming and in pain again. I really, really hope that treating the EPM will help her MFM episodes not be so severe. Until then, I'm going to try giving her an oral steroid to bring down any inflammation in the nervous system and hopefully make her feel better.


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## BlindHorseEnthusiast4582 (Apr 11, 2016)

I hate that she is feeling bad again, but hopefully you'll get it all worked out with this new medication!


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## Light (Mar 4, 2012)

I am sorry she is having another set back. 

I don't know anything about this disease but thought I would just throw this out there so to speak.

If the trimming is causing this kind of response, what if you only had the farrier trim two feet at a time. So do the fronts and then in a couple of weeks do the backs? Just wondering if it might help. 

Is she still barefoot? Is she having trouble while he is trimming her? Can you check with your vet if you can give her anything prior to her being done? Do you think it is the trimming itself that sets off an episode or hoof pain after the trim? Does your farrier use a hoof stand? Does she get frequent breaks to take a walk and move around during the trim? 

Sorry for all the questions. 

I have a senior mare that has difficulty with arthritis during her farrier appointments and had to do some adjustments in order to keep her from being sore afterwards and also to keep the farrier alive.


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## Espy (Feb 25, 2015)

Thanks for the responses! She is past her little muscle episode now. I think I'm finally getting the hang of it. I think her high protein diet and supplements helped her pull out of it before it got bad. No more spasms.

More importantly, the EPM drugs are working! She is moving much freer now and is even able to pick up a trot. She stands more like a normal horse now and is able to pivot without being incredibly slow or stepping on herself. Most importantly, she has started to act like an actual horse again. I gave her a bath on day 2 of treatment and afterwards she tried to roll! She couldn't do it with all that muscle loss, but she tried. I haven't seen her try to roll in a very long time. I'm feeling optimistic. I've even been able to exercise her lightly (short sessions of fast walking and a tiny bit of trotting. Nothing beyond her limits).

Those drugs are quite hard on her, though. She seems to react with gut pain. About an hour after getting the meds she starts behaving in a colic-like manner. She paws at the ground and looks at her belly and is restless. I know it isn't real colic because she poops fine. And banamine takes care of it. But I sure hope this reaction to the drugs stops happening soon. I hate giving her so much banamine. She's had to have it all 4 days so far.

Things are starting to make sense now. MFM and EPM must work sort of synergistically. She didn't have classic presentations of either disease, so it made them hard to separate and diagnose. I couldn't tell if she was neurological or not because the muscle stiffness and wasting alters her gait and movement as well. Looking back on it, though, I definitely see it. Really the only thing that made me want to test for EPM was just the extent of muscle wasting and the fact that the wasting was minorly lopsided (more wasting on the left). Not typical for MFM, so there must have been something else. I think we are on a better path now that I know there is more than one thing. Now I can treat both things and maybe things will be okay. I feel really encouraged that she came out of her muscle episode so fast. Before if she started spasming we were in for 1+ month of serious problems and possibly death. This one was much more minor and only lasted about 2 days. Yay!



lightning said:


> I am sorry she is having another set back.
> 
> I don't know anything about this disease but thought I would just throw this out there so to speak.
> 
> ...


I'm pretty sure I know why having her feet done set her back. I honestly expected it to. She had her feet done shortly before entering this second episode, and at that point we put shoes on her. We thought it might help whatever pain she was having. This was before I really understood what was happening. Shortly after putting shoes on her, she entered her second episode and she was so sick. We were much too afraid to mess with her feet. I thought it might kill her. So she went more than twice as long as she should have without her feet being done. Pair that with having shoes on (no natural wear) and the fact that the high protein diet makes her feet grow really fast, and we had a problem. Her feet were so long. So not only did we have to trim her very long feet, we also had to pull all of the shoes off. My farrier took the smallest amount off possible while trimming, but I think it was pulling the shoes that caused her to hurt again.

Now that the shoes are off, I think we'll have an easier time. I think I want her on a more frequent schedule than the other horses. I want to change things as little as possible for her, so I'll have the farrier come out twice as often to just take small bits off of her feet to keep it consistent as possible. And no shoes ever again!

To answer some of your questions, I'm not sure what exactly sets it off. It was either the pain of going from shoes to barefoot as well as changing her angles or the actual cutting of hoof matter. Maybe both. Hard to say.

She gets a dose of banamine before getting her feet done. We found before we even knew it was her muscles that were hurting that banamine helped her stand easier. And actually this time she was great. No complaints and balanced perfectly. I was watching carefully and did request that she have breaks, but she didn't seem to be in any pain at all during the process. My farrier is very sensitive to her needs. The spasming episode started the next day.

So anyways, things are good here. At the end of EPM treatment, I'll post a video. I think she's going to be feeling much better at that point!


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## redbarron1010 (Mar 11, 2017)

Wow, what journey with your mare, I read the whole thing rooting for her! You are a great owner hanging in there with her. So glad you have a diagnosis and are on the road to managing her symptoms. You could probably be an equine vet by now! Good luck with her and please keep us posted on your beautiful girl.


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## Espy (Feb 25, 2015)

Thanks! I'm actually studying to become a vet of some kind, likely equine, so at least this experience has been a learning experience in that regard.

Supposedly I'm FINALLY supposed to be getting my results for her PSSM2/MFM/RER test today. Supposedly. We shall see. I am dying to see those results. Just dying. I had a dream about it last night, haha. In my dream she was all clear for all variants and I was really surprised. I doubt that will be the actual outcome!


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## 3Horses2DogsandaCat (Apr 19, 2016)

I haven't read this for a while, but I'm glad to hear she is doing better. EPM can show up in such strange ways. I had no idea mine had it, but he is like a new horse after treatment with Protazil. Which medication is your horse on?

I hope you get positive results from her testing!


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## Espy (Feb 25, 2015)

She is on decoquinate and levamisole. She is on day 8 of the 10 day treatment. It has helped her at least be more mobile. She doesn't drag her feet when she walks anymore and is able to turn in a circle with more ease. But recovery probably won't be that simple. She is definitely still sore from the whole muscle thing, and weak from the muscle loss. She has no energy. I had to stop hand walking her because it was making her be in pain. I guess I need to keep messing with her diet. Maybe I'll try adding alfalfa back in or something. At least I can see what was neurological and what is muscles. And I'm really hoping that not having EPM will help her not have the deadly attacks anymore. I can work on a sore, atrophied horse. I can't work on a horse that is literally dying.


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## shrelly (Jul 15, 2017)

*Cbd*

store.cbdequus.com. this place has great cud for horses. Helped my horse a lot that had joint issues now he is running around happy.


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## Espy (Feb 25, 2015)

Guys, I finally have her results back from EquiSeq.

She is n/P3 and n/Px. This means that she is officially diagnosed with myofribillar myopathy and is at risk for recurrent exertional rhabdomyolysis, although I haven't yet seen the classic symptoms of that, such as increased serum CK levels. There is also speculation that the Px gene acts as a modifier that makes the clinical signs of the other myopathies worse. So that explains a few things. Hmm, maybe I should try dantrolene...

So that's that. The poor girl is pretty messed up.


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## Espy (Feb 25, 2015)

Sorry for the double post but it is too late to edit my last one and this typo is really bugging me. I meant to type "myofibrillar myopathy".


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## Light (Mar 4, 2012)

Hi, 

I am sorry for the diagnosis but at least you have a real answer now. I won't pretend to know about what she has. Is she able to live a decent somewhat normal life with this? Can she be kept comfortable with proper meds and care? I sure hope so.


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## redbarron1010 (Mar 11, 2017)

So sorry about the diagnosis, but it may help you find the right path. Poor girl :-(


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## Espy (Feb 25, 2015)

It's hard to know for sure yet if this can be managed. Currently it is not well managed. If I can't get it under control, than no, she won't be able to live a decent life and I'll have to euthanize. Some horses with these disorders can be managed and some can't.


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## egrogan (Jun 1, 2011)

Thanks for sharing the update @Espy. I don't know much about the conditions you're facing but have learned a lot from you post. I wish you best of luck as you make decisions about next steps.


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## Espy (Feb 25, 2015)

Hmm, I'd really like to write something up to go on this forum, just to increase awareness. These muscle diseases are way more prevalent than I ever wanted to believe, and awareness is generally so low. I had no idea they existed before my horse got really sick.


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## gottatrot (Jan 9, 2011)

I agree, this information is important for horse owners to know.

I felt the same way after my horse got laminitis from oats, and after her severe muscle wasting from vitamin E deficiency. It makes me feel responsible to share the information where I can.

It's good of you to help educate us fellow horse owners, because we may run into the same type of issues in the future with our horses.


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## Espy (Feb 25, 2015)

Well, our story ends here. Esperanza has developed peritonitis of unknown cause and my vet and I have decided that it isn't worth trying to try to treat. She never did improve much since the last time I posted, the muscle wasting never stopped, and now her abdomen is full of fluid and painful. I can ask no more of her and it's the right thing to do to let her go even though it's gutting me to make that call. We both fought valiantly but did not win in the end. She will be euthanized tomorrow.

</3

I'm glad I at least got a sticky posted about myopathies that includes her videos. I hope she can continue to be an ambassador for horses with myopathies.

RIP. No more pain.


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## HombresArablegacy (Oct 12, 2013)

I'm so very sorry for you and your mare. You both gave it your best. No one can ask for more.


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## JCnGrace (Apr 28, 2013)

My sympathies go out to you Espy. You loved and cared for her and did more for her than a lot of other people would be willing to do so I hope at some point in the future you can take comfort in the fact you went above and beyond. Hugs


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## 3Horses2DogsandaCat (Apr 19, 2016)

I'm so sorry you had to go through this. You did everything you could for her.


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## Espy (Feb 25, 2015)

I appreciate your sympathies. I would have gone as far as I needed to to save this horse. She is really, really special to me. But my vet said this is the end and I love her enough to let her go.

Anyways. It's been educational. That's for sure. I hope some of you will read my sticky and get the info on that.

I'll still be around, of course. I have 3 more horses and am always looking to learn more. There is still a lot about horses I don't know. I also hope to be able to help anyone else who comes to the health forum with a horse with muscle symptoms.

Thanks, everyone, so much for all of the insight you provided on my mare. We wouldn't have gotten so far without all of your help. It didn't have the outcome I hoped for, but I am at peace knowing that I did everything I could. Still very sad, but at peace. Much more than many other people would have done.

Her appointment is 3 hours from now. And then she will be gone, but no longer in pain.


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## BlindHorseEnthusiast4582 (Apr 11, 2016)

So sorry it has to end like this, but as you said, you can have peace in the fact that you did everything possible to help her. RIP to your beautiful girl.


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## egrogan (Jun 1, 2011)

Oh Espy, just seeing this now. So sorry that you have had to make this decision for her. Thank you for sharing her journey with us and helping other horses by allowing so many to learn from her experience.


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## KigerQueen (Jun 16, 2013)

after reading your sticky it makes me question my mares neck injury diagnosis... how much do the tests run?


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## Espy (Feb 25, 2015)

Thank you so much for the comments. I really appreciate them. I really hope to continue to help others not experience what I did.

KigerQueen, I'm going to PM you because mods have warned me about strict advertising rules.


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## Light (Mar 4, 2012)

I am so sorry.


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## gottatrot (Jan 9, 2011)

Very sad about sweet Esperanza. My thoughts are with you.


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## jaydee (May 10, 2012)

I'm so sorry to hear this, even knowing its the right thing to do doesn't make the pain of loss any easier


Thank you so much for taking the time to share everything that you've learnt along the way. 
http://www.horseforum.com/horse-health/information-myopathies-pssm1-pssm2-mfm-rer-772025/


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## SilverMaple (Jun 24, 2017)

I'm so sorry. I've saved your Myopathies information post.


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