Equine case study – Mikey
by Lara Kats BSc Msc,Chartered Veterinary Physiotherapist, ACPAT cat A
I was called out recently to see a horse (Mikey), a 14 year old cob gelding with a history of bucking on trot to canter transitions. Mikey had been purchased about a year previously as a first horse for a teenage girl, who had lessons for two years before that. Mikey was not vetted on purchase. In addition to the bucking, Mikey had always objected to being tacked up, nipping on seeing the saddle. The saddle had not been checked by a saddler, as it had come with him and had been said to be a good fit by the sellers. The girl’s aspirations were to do a few shows, a bit of jumping and hacking. At the time of my first visit Mikey was only being ridden in the outdoor school, about 6 days a week, as he wouldn’t go out without company and no suitable company was available at the livery yard where he was kept. The owner hadn’t had any riding lessons since buying Mikey. He was turned out throughout the summer and stabled at night in winter.
On observation Mikey showed a mild right hind limb lameness in trot on tarmac, the lameness was inconsistent in the arena. On the lunge he showed a general lack of suppleness, but specifically on the right rein in trot, and on the left rein in canter. Most noticeable was the rider/handler’s nervousness and inexperience. The assessment had to be aborted when Mikey became a bit naughty. No bucking was observed. Ridden, it was evident that the girl was still very nervous and not a very educated rider. Mikey was very tense, had high head carriage and was heavy on the forehand, and was not engaging his hind limbs well. I decided to abort the ridden assessment without looking at the canter transitions, choosing not to be the responsible party in case of demonstrative bucking.
On assessment in the stable the horse showed a degree of muscle wastage in the right gluteals (top of his bum) and hamstrings (upper part of the leg). The muscle wastage indicated that the hind limb lameness was not recent. Mikey also had pain and muscle spasm throughout his back. The saddle appeared to be too wide.
So, what next? Here we have a horse who is lame, has a poorly fitting saddle, is doing fairly repetitive but ineffective (rather, counter-productive) work, and has back pain. The owner is very dedicated but also very inexperienced. I explained that we would have to involve a number of people to proceed. Firstly, the vet would have to assess Mikey’s lameness. Secondly, a saddler would need to come and check the saddle. Thirdly, once Mikey was fit to return to work, it would be essential to enlist the help of a good riding instructor. The girl and her mum, thankfully, were very receptive to this and really wanted what to do what was best for him. I treated Mikey’s back pain with manual techniques and a muscle stimulator to help alleviate the pain and muscle spasm and explained that without involving the vet and the saddler next, any further physio treatment would not be terribly effective. Most back pain in horses is secondary to problems elsewhere. If a horse is lame, or has pain from poorly fitting tack and continues to be worked, he will eventually develop aches and pains in other places. More often than not, these manifest in the back muscles. This then leads to altered movement patterns as the horse tries hard to do his job despite his disabilities. In Mikey’s case, he was trying to alleviate the pain in his right hind by moving his bodyweight forwards. At the same time, he was carrying his head very high and arching his back because he was unable to use his abdominal muscles properly which meant he couldn’t stretch his back muscles. Eventually this cycle, not helped by the lack of skilled riding, made him become too sore. Work became too difficult so he resorted to bucking.
In the following two weeks the vet did a lameness work up, x-rayed Mikey’s hind limbs, diagnosed degenerative changes (osteoarthritis) in the right hock which he then medicated. The saddler was able to exchange Mikey’s saddle for a much better fitting one. I treated Mikey’s back until he was comfortable enough to be ridden (two sessions). Again, this consisted of a combination of manual techniques and a muscle stimulator to reduce pain and muscle spasm, as well as a stretching program for Mikey’s owner to do with him. Mikey had also moved to a new yard by this time where there was a good instructor on site. I was really keen for Mikey to be ridden by an instructor until he was a bit stronger, more flexible and more obedient. It was important that he re-learn how to engage his hind limbs, use his abdominal muscles, take the weight off his forehand and carry himself properly. He started off with very light schooling, but after a further two weeks was starting to move very nicely, and was showing no problems on trot to canter transitions. Though still apprehensive when being girthed up, he was better behaved being tacked up. During this period I treated Mikey two more times, in close cooperation with the instructor who was receptive to suggestions for exercises and gave brilliant feedback. Gradually, his owner started riding him and was having regular lessons as well as starting to hack him out with friends at the new yard. Last I heard, they had been to a few shows and all was going well. A happy ending for Mikey and his owner.
What I hope this case study demonstrates is that sometimes it really is necessary to involve a number of different people in rehabilitating a horse. Physiotherapy alone would not have sorted the underlying lameness problem. Medicating the hock and changing the saddle would not have fixed the back pain. Without a good trainer, Mikey would not have been able alter his way of moving. The most difficult part about being a horse physio is getting owners to understand the importance of investing in the right people at the right time. Most horses are remarkably forgiving and biddable considering how badly designed they are for many of the things we ask them to do for us. I’ve seen horses perform beautifully whilst enduring high levels of pain and damage, at both ends of the athletic spectrum. The most gratifying part of my job is helping people understand that in accepting our own and our horses’ limitations and making the most of the professionals, our horses get better, happier and healthier.
Lara Kats BSc Msc
Chartered Veterinary Physiotherapist, ACPAT cat A
The Veterinary Physiotherapy Clinic, Goldenacre, Aiket Road, Dunlop KA3 4BW