Sacroiliac Injury

[racipaci]

Dave has just been diagnosed with having a possible Sacroiliac Injury. The extent of the injury is not known but it is likely he did it when he was a racehorse.

The good news is this accounts for his odd behaviour when being asked to collect and work harder, but the bad news is his prognosis doesn't look too great.

Just wondering if anyone has had any experience of this kind of injury and if so how it was treated or managed?

it obviously all depends on the bone scan and ultra scan but I'd like to know a little bit more in the meantime.

:)

[FinnegansMum]

THERE IS HOPE! A friend of your sent me a message on the Frogpool forum, asking me to come on here and reply to you.

My horse, Finnegan, became very very lame in around April this year. A scintigraphy was done (nuclear scan) and it showed damage to the sacroilic area. The sacroilic is an easy joint to damage, but a very difficult one to treat. It is around 10 inches down from the hind quarters, and is a joint that essentially "floats" and is held in place by hundred of little muscles. I was told he would more than likely be retired, and be a "happy Hacker"

Finnegan was put on 6 weeks box rest. After 3 weeks, I was asked to walk him out in hand for five minutes a day. After the first week of walking out (with sedation and a chiffony - he's a TB!!!) it was increased by two minutes so 7 minutes walking out for a week, then nine minutes and so on. When walking out, Finn had to move back ten paces before we started, then back ten paces after we had finished. This apparently realigns the joint.

After 3 weeks of walking out, the vet re-attended. He was very encouraged by the improvement. Another 6 weeks of box rest, with someone riding him twenty minutes a day of the road, at a loose rein (as light a jockey as possible). After six weeks of this, the vet re-attended. Finnegan had improved beyond all reasonable expectations. Taking it very slowly, bringing him back into work, with lots of road work and minimal schooling. I am not schooling 3 or 4 times a week, incorporating some pole work to build his legs up, and he is expected to jump again next year.

Overall, I did everything the vet asked me to do - I had a stop watch to ensure our walks were the right amount of time, and vared where we walked every day. I am not ashamed to say I sat in my boys stable and sobbed like a baby, and begged him to get well - for himself and for me.

I know of two other people who have been through the same experience, and been told to expect the horse never to come back into full work. All three horses (mine and the other two) are now back (or coming back) into full work.

It is a devastating prognosis - and I can't promise your result will be the same as mine. But with the right attitude (if the horse doesn't give up, then dont' you either) and the right amount of care in your work, then why should be not come right again?

I wish you the absolute BEST OF LUCK. I am sure Dave will be just fine.

Take care
Estelle & Finn
xxx

[racipaci]

thanks for that, it's good to know there is hope :)

The only thing I worry about is that Dave has obviously injured himself a long time ago and seems to have adpated to the injury. He's not lame and shows no unlevelness when he's lunged etc, the problem only shows when he's asked to collect and use his hindquarters or in the flexion test.

I just wonder how much can be done for him when he has such a long standing problem? I know it all depends on the scans and I've got to be patient.

Thanks for taking the time to come on here and reply, I really appreciate it and hope that Finn continues to improve and hopefullt Dave will do the same :)

[Sophini]

Rach - estelle asked me to add that she doesn't know when Finn got his injury and the week before his diagnosis she had been competing and came second :D

Fingers crossed for Dave but am sure he will be ok with time

Soph xxx

[intouch]

Very gentle Equine Touch or Bowen will go a long way towards helping.

[galadriel]

There are more SI problems out there than most people would guess. The severity of the SI problem also varies from horse to horse. Esther.D and Steve.R's Pablo has been in treatment for his SI problem for a long time :( poor kid. But some are relatively minor, and only take a little while of treatment to get over them.

Of my OTTB's, both of them had SI complications (long-standing). One has completely overcome it with only a little treatment. The other will probably still be coping with hers for as long as she's alive, despite the fact that I work on it regularly.

[tasha]

Didn't Bebe have a SI injury? I think of combination of treeless saddles and shoeing helped her. Might be worth a PM.

[virtuallyhorses]

SI injuries are quite common, you may have heard of them as Hunter's bumps. The prognosis is generally good and the treatment is relatively simple - rest. Sometimes the vet may use injections of irritants to cause the ligament to scar more evenly. Basically you are looking at around a 3mth rehabilitation. During the rehab time for the actual SI injury the muscles should also recover - as muscles recover faster than ligaments. However, a rehab period to correct any 'learned' behaviours is also helpful.

Obviously the length of treatment and the long term prognosis depends on the amount of injury to the area - if the ligament is completely severed (highly unlikely since this is an incredibly tough ligament) then the sacral area will be completely unstable. However the vast majority are partial tears of various seriousness. The most obvious sign of this is that the head of the iliac on the torn side rises - giving the uneven appearance of the horse from the rear.

Many racehorses and jumpers suffer SI injuries, as long as they are allowed to heal they can continue long and happy lives. Once healed they will usually retain and uneveness in the 'hips' and croup. Imp has definitely injured his SI at some stage - he's a little skewiff (if you look carefully on level ground) it certainly doesn't affect him as a riding horse and he lives a happy and healthy life. I've attached a photo of Imp's SI - the red line shows the head of the tuber sacrae - where you see the effects of an SI injury. (Ignore the muscle atrophy that was a different injury earlier this year)

If you are talking about an SI injury it shouldn't affect flexion tests or collection. These would result from other injuries or from something else - unrelated. These would more likely be affected by lumbar or other spinal injuries.

[galadriel]

If you are talking about an SI injury it shouldn't affect flexion tests or collection. These would result from other injuries or from something else - unrelated.

Actually, an SI injury can be quite profound. The muscles involved in supporting the SI can be injured, weakened, wasted, scarred. Without a strong SI, the horse literally cannot collect. There's no way he can rock back and carry more weight on his hindquarter.

The SI is also quite involved in the hind legs; if it's stressed by lifting/flexing a hind leg, it could certainly affect flexion tests. So much in the back is both directly and indirectly connected to everything else...anything that goes on in the back affects the rest of the back, affects locomotion, affects EVERYthing.

[Bebe]

I actually bought Bebe coming off a years field rest for an SI injury which vets didn't think she'd recover from. It took a fair while to sort her out, a combination of changing to a treelesss saddle, finding a good chiropractor & bowen therapist, lots and lots of work on straight lines and, for a short period of time, remedial shoeing behind to help her out.

The weakness in her SI is still there, always will be as the ligaments which hold the joint in place are severely weakened and Bebe now relies on muscle mass to hold everything together as it should be. She isn't physically able to withstand more than the odd small jump whilst out hacking (tried it and it made her sore) but she is perfectly sound and happy doing long hacks, her schooling is coming along really nicely, we've done a couple of dressage tests, local shows and a Trec too with no problems.

[Lucy J]

there are a couple of vets who work at the Animal Health Trust in Cambridgeshire who really know there stuff re SI injuries. there are new procedures which can help, i was reading about it a while back. chiropractic work always helps as does a regular exercise routine. see what the vet comes back with depends on the type and severity of the problem.