Presenting Concern:
Quarter is a 13 year old Quarter horse who was used for many years in pony club. She developed a significant, bilateral front limb lameness several years ago. The decision was made to retire her after she was given a poor prognosis with a diagnosis of malformation of the coffin bone. She returned to the previous owner, who was interested in pursuing a diagnosis and further treatment to make her comfortable. She presented to Dr. Ashman with severe valgus of the front limbs (feet turned out). She was barely able to walk initially. The owner’s daughter is planning to attend veterinary school and was invested in working side by side with Dr. Ashman to help Quarter. She played a tremendous part in Quarter’s evaluation, treatment, and rehabilitation.
- Atrophy (muscle loss) over both scapulas / shoulder region
- Sensitivity to touch in saddle region on both sides (right more severe) / shoulder asymmetry severe
- Severe back pain to gentle palpation (left worse)
- Camped under behind (hind limbs stayed tucked under body)
- Coffin joint inflammation of both front (effusion)
- Severe paddling of front limbs
- Neck held in neutral position – unable to lift of lower her neck
- Abnormal scapular motion
- Inability to engage pelvis during movement – would plod along on front limbs
- Pivoting on the front was impossible and painful to watch
Diagnostics:
We started with survey radiographs for the farrier. There was significant medial – lateral imbalance of both front feet with negative angles behind. The farrier was not to blame, Quarter’s stance was leading to imbalance and her camped under rear limbs were worsening her negative angles. In addition, neck xrays uncovered significant arthritic change in Quarter’s lower neck. Quarter’s feet were blocked and her lameness improved only slightly. This confirmed that her primary lameness was not originating from her feet.
Quarter’s back and pelvic pain was treated with ultrasound guided injections. This allowed Quarter to engage her hind end and actually unload her front limbs. It is important to note that Quarter’s treatments were done in stages. She has spent YEARS compensating for her pain and this had to be unraveled carefully. Treating her too aggressively could cause decompensation, which could lead to her literally falling apart before our eyes. In between treatments, her owners work diligently to keep her moving lightly.
The next step to helping Quarter was to treat her thoracic sling / brachial plexus and coffin joint inflammation. Quarter’s feet immediately began to improve, and her stance slowly returned to normal.
Finally, we treated Quarter’s neck and nerve roots using ultrasound guided injections. Her elbow pathology was also addressed.
Results:
Quarter improved with each treatment. Within 2 weeks of her last treatment, we received an update from her owner.
“Life has been a bit crazy lately, but this morning this pony put a lot into perspective. She is mostly happy to see me, but this morning, seeing her move so well was good for my soul. When we got her, she could barely get around and could NOT trot. Our girl has made amazing progress.”
Seeing Quarter trot across the field was so rewarding. This pony was very close to euthanasia, as she was not even pasture sound. We anticipate that Quarter will continue to improve once we can restart her rehabilitation lunging program. The recent snow and ice have prevented her owners from continuing her work but they have plans to resume as soon as the footing is safe. Thank you for trusting us with Quarter’s care. Treating her lameness was a tall order but we are very excited to see how much progress she has made.