Locking Stifle

[majobgeorge]

When I got to the stable this morning Polly did not pop her head over the door as she usually does. I knew something was wrong straight away. Her back leg was twisted out and straight and she could not walk. Complete panic set in with me as I thought she had done something awful. The vet came quickly luckily and told me she has a locked stifle. He tried to free it which is a hideous procedure which I am sure looks worse than it is but it scared me to death. He freed it but it went again straight away. He had to sedate her and freed it twice more but it locked again straight away. It was not easy to do as its really heavy work and he felt he was not going to be able to do it. He has told me that she needs to have an op to free it and this will have to be done this week. She is in her stable with her leg locked and I am distraught. I have read about the op and everyone says it is the last resort and exercise and rehabilitation are best, however the vet cant understand why it has happened as she is quite well muscled and just 6 years old. Has anyone had any experience of this. Any ideas or suggestion will be very gratefully received. Thank you

[cadeby]

I only have experience of it in young horses. My new Forest filly Solitaire has had a locking stifle on and off since she was 18 months old. She's now 3. The first time it happened coincided with a sudden growth spurt at the rear. My vet says it's classic stifle lock seen in immature horses and that she will grow out of it and that no intervention is necessary. Solitaire can trot and canter with her leg "falling off". It looks horrific but doesn't seem to bother or hurt her at all! She's also learnt to put it back into place herself by taking a few steps backwards.

With Polly being 6 years old, and given the difficulty the vet had in rotating the patella back into place, it does sound like her problem is something different. Has the vet x-rayed the joint? Is her hind hoof conformation correct? Is it possible she might have fallen in her stable and damaged the joint?

I would definitely ask for further tests and/or a second opinion before agreeing to the op.
Good luck xx

[majobgeorge]

It is still locked. I am get more worried. She is being so good bless her, just stood there not complaining. The more I read about the op the less I like the idea. I think x-rays and a second opinion are definitely in order. She does not seem to have any idea how to free it herself or like you say maybe its not locked it could be something else, however after the vet unlocked it each time she did walk round ok for a few steps before it went again. I have a sleepless night ahead.

[cadeby]

I do think it is a locking stifle. When I said "maybe her problem is something different", I meant different in the way it's been caused, ie. Polly isn't a baby so her locking stifle probably isn't a classic case caused by immaturity. I just didn't word it very well. Sorry.

Try not to have a sleepless night (easier said than done!) The literature says it's not painful for the horse. As my vet said to me when I asked if my filly needed bute - stifles are designed to lock so that horses can sleep standing up. It's just the natural locking process operating at the wrong time
It's good that she's calm and not complaining in her box. I bet she'll have a better night than you!

Definitely read up as much as you can and take as much advice as you can get. I wonder if it would be worthwhile getting an equine physio in to check her conformation and musculature? Hopefully somebody on here will have experienced this in an older horse and can help xx

[majobgeorge]

Thank you for your comments, you have definitely made me feel better. Pollys reg name is Twywell Amber Leigh and I know you have Twywell Rosie Leigh, so you will be aware of the wonderful temperament she has. I will let you know how we get on tomorrow.

[tinkerdorisalison]

My pony Tinker had this when she was 3/4 yrs old- she was being stabled more as it was around bonfire night time (I was horrified as it does look awful) the vet said turn her out and let her get on with it, and she has pretty much lived out ever since (16 now)

Hope that it is just growth related and Polly is ok

[flintfootfilly]

I don't have direct experience of this. Well, I did have a mare who had an intermittently locking stifle, but it only ever did it for a split second before she could free it.

However, there is one angle which I don't think is talked about much. I only know of it because of reading up about muscle disease with my gang:

The mechanical lameness chapter by Beth Valentine in the Ross Dyson lameness book (the main veterinary text book on lamenesses - about 1100 pages of lameness stuff!) does say "Decreased force of muscle contraction of thigh muscles.... may be the explanation for upward fixation of the patella occurring in horses with underlying myopathy, causing weak or stiff muscles".

So with that in mind, and because my gang have all shown muscle problems which increasingly appear to be the result of long term dietary selenium deficienty, I would suggest:

1) make sure she is getting a full daily ration of a vit/min supplement or balancer that contains around 1mg of organic selenium. Blue Chip original is the one I would currently suggest. (Inorganic selenium aka sodium selenite has not brought about any improvement in muscle function in my gang, so I wouldn't bother with any vits/mins that only contain that). If it is being caused by muscle problems due to selenium deficiency, then it would be several months before you'd see an improvement (based on the muscle enzyme results for my gang once they started on organic selenium).

2) have a blood test to check the main muscle enzymes: definitely CK (creatine kinase) which is the only one which is indicative of muscle damage and nothing else, but possibly also test AST and LDH (which are both liver and/or muscle damage indicators). That test would give you an idea whether there was a muscle problem underlying it, but I would stick with giving the vits/mins whatever.

Only a suggestion (and not based on any knowledge or experience), but would she be more able to free her stifle if she was able to move about in the field/yard rather than confined to a stable? I've heard some vets suggest to back the horse up a few strides to free the stifle, but don't know how easy that is.

It does sound as though if it's happening for a lot of the time at the moment, you might have to think of an op.

The book mentions surgery should only be considered for severe fixation in those who are unresponsive to exercise or medication or if they are continually locked for several days. It also mentions that estrogens can be given once a week for several weeks, and that these may help relax the tendon and ligament, so maybe that's something to consider? IM estradiol cypionate - I know nothing about it except what I just read in that chapter.

If you're not sure what type of selenium is in her feed or vits/mins, then if you let me know the name of it I can check it if it's on my own little spreadsheet of balancers.

Like I say, it may or may not be anything to do with diet, but at least it's something which is easy and relatively cheap to adjust if necessary.

Hope you find a good way forward.

Sarah

[majobgeorge]

Sarah
Thank you so much for your response. Unfortunately this morning she is still locked so I am waiting for the vet to call me back to see what happens. You have got me thinking though as in November Polly had a blood test in November as she spent a few days off her food, however she had just had her teeth done and the vet felt that they had been filed down way too much so this could be the answer. Her bloods had a raised liver enzyme which the vet said could indicate she had just had a virus that she was getting over. I have noticed when schooling Polly that she does get tired quite quickly. I dont know if it is because she is young and finds the work hard or if I am imagining it now. I have fed her since March on baileys No 14 which is the low cal balancer and Hi Fi Lite. I have just started introducing Baileys No4 last week as I feel that her coat is not as healthy as it was last year when she was on all sorts of rocket fuel at the livery yard I was on. She has a muti vit added to that. Thank you for your interest
Jackie

[flintfootfilly]

Right, I would really strongly suggest you ask for a copy of the full blood report that was done in November, and then see for yourself exactly which things were looking high or low. Some vets don't report things that are only marginally high or low, but they can still be significant. The report will include Polly's value for each cell count or biochemical, as well as a reference range into which 90% of "normal" horses would lie.

If it tested CK, it'd be worth checking what level that was. Our lab's normal range is up to 225u/l, and my ponies whose levels are 600 or above are quite limited in their work - grinding to a halt from an active walk or trot. One is up in the 3,000s and he has a very stilted hindlimb action and can only manage a relatively slow unadjustable walk, or a very stop/start trot. The most normal one has CK around 200-300. He does a bit of grinding to a halt, but mainly he just seems reluctant and lack-lustre.

The Baileys LoCal provides 1mg of selenium in a ration for a 500kg horse, but it is half organic selenium and half inorganic, so only provides 0.5mg organic selenium (which is the one which seems to be making a difference with my gang, and is known to be more bioavailable). Blue Chip balancers contain both organic and inorganic, but at around twice the concentration, so if there's any chance that her forage might be deficient in selenium and/or there are muscle problems, then I'd suggest Blue Chip as being the one more likely to help.

Just looked up the No.4 conditioning feed online and I see it's not really recommended for good doers. I don't know what's in there selenium-wise and the website didn't way. If you're going to continue with the no.4 and the multi-vit, it really is worth checking whether the multi vit has organic selenium (selenium yeast) or sodium selenite. A lot have the (cheaper and less effective) sodium selenite, and only a few have the organic selenium which is the one I'd aim for.

Like I say, I can't say whether that's the root cause of her stifle problem, but it is certainly a possibility.

Sarah

[majobgeorge]

Thank you Sarah,
Unfortunately things have gone from bad to worse. It would appear that her leg is locked and is supporting the other leg which may be the one with the problem. She will only put weight on the locked leg which is highly unusual, she will not put weight on her other hind. The vet does not know if she has a muscle injury or possibly a fracture in her stifle. She has had to have a steroid injection to see if that works tonight then if no improvement overnight x-rays and scans tomorrow. I can't even bring myself to think about what it might all mean. She is still stood as gold as gold in her stable.
Jackie

[harveydales]

Oh no, poor Polly, bless her! Really hoping it resolves itself overnight and is not as serious as you are suspecting.

[flintfootfilly]

I'm so sorry to hear there's no improvement yet. Have just looked again in that book and I can't find anything else that might be useful. Wish I could come up with some other ideas for you, but I'm afraid I just can't find anything else.

Hope she's more comfortable by morning, and that the scans are able to pinpoint what's going on, and help decide on the best course of action.

Sarah x

[heathera]

I'm so sorry to read there might be a problem on her other leg. I don't have any suggestions other than those made already but the fact she's calm and content is, hopefully, a good sign that nothing major is broken or damaged.

Sending lots of good thoughts for the X-rays showing what's going on and that it's easily fixable.

[Debbie]

Blossom was the Locking Stifle/Sticky Stifle Queen when she was growing up. It's so distressing to see the first time! They look like they've totally broken their leg.

Typically Blossom's would get sticky or lock out when she had a growth spurt and her hindleg conformation went straight. I only bothered once to push her backwards to get the leg to pop back in. It went back in, but she took a step and it locked out again. What would happen is over the course of two or three days, her leg would lock outrepeatedly, so she devised her own method of doing a tiny circle over the top of the locked stifle and it would go back in all on it's own. After about three days tops, the leg would stabilize and stop locking out.

At one point she even had both hinds lock out on her, but that was a one off. She's pretty much outgrown it. The only time she gets sticky stifles is if she's been using her hind feet a lot. I also notice if the toes on her hinds get long, she'll begin to get sticky, so I keep them rounded for her.

During the episodes, I would offer her arnica and ruta grav homeopathic tablets for any pain/puffiness and for supporting the tendons. And I'd massage all over her hindquarters, both the affected limb and the supporting leg.

If I were in your shoes and concerned about possible problems (like from a fracture/kick, etc), I'd skip the steroid shot altogether and simply get the xrays done. I've met ponies who have had the surgery and they recovered very well. Best of luck, and I do hope she's only going through a growth phase for you and be right as rain soon.

Oh crud, I've got more time this morning and was able to more thoroughly read your other post. Sending along the most positive vibes possible that she's alright and it's a muscle tweak somehow

[majobgeorge]

Thank you all so much for your replies. Polly still has one stifle locked and her other leg can not take any weight. X-rays do not show any fractures so it looks like she may have done the splits or something similar and pulled or ripped a muscle. Thank goodness no fractures however still feel helpless as the vet cannot definitely decide what is going on and has given her another steroid injection and told me box rest for a week and see how she is then. She cant walk at all and just pivots round on her locked leg. It is breaking my heart seeing her like this. Luckily she remains calm as does my freinds horse who is kept with her, however I cant keep the other one in with her indefinitely so will have to look into getting another companion that can stay in with Polly during the day and go out at night. Have any of you had experience of muscle injuries, would you expect her not to be able to put any weight on that injured leg at all. It is worying me that it is 4 days now and no improvement or am I expecting too much too soon. Once again thank you for all the info and support.
Jackie