Luxating Patellas (aka Locking Stifles) in Minis

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dragonfur

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I have a yearling filly and an 8 YO gelding with locking stifles. I took the filly to a vet lameness specialist who advocated cutting one of the ligaments that holds the patella in place. He says the horses with this surgery can still stand up to sleep, but with a bit more awareness, as the ligament that gets cut is the one that locks the stifle while they sleep standing.
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Have any of you had the stifle problems in any of your minis? What kind of treatment did they get, and did it work? What kind of surgery was used, if any was?

A clinic not far from the first one uses a couple of other methods that do not involve severing the ligament (they wouldn't tell me what without me bringing the horse in for evaluation first), but their methods are many times more expensive than the ligament cutting.
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I'd just like to know whether the less expensive method (the ligament severing) is really a good idea, especially on a yearling filly. (I'm considering trying it on the gelding first. I can't drive him until his is cleared up, but she has more growing to do before I can train her to drive.)
 
hi, I have a 6 year old mare who suffers from this. I was very upset when I found out as I had bought her to reproduce but due to this condition I can't/won't. I have looked into all options and I think I will try laser treatment first. I did find a good article that explains the splitting of the ligament well.

http://www.equinescienceupdate.co.uk/patlig.htm

Good luck
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I would suggest you talk to Leia (Hobbyhorse) about this issue. She has had lots of experience with this, is well versed and is not afraid to discuss it.

I have been told by a vet that on the young horses, if they get lots of hill work or long lining over trot poles (in a collected manner with hinds up underneath), it will help strengthen the stifle muscles and tighten the tendons and ligaments. Loose tendons/ligaments and poor muscling are allowing it to slip out of the groove at the end of the bone which causes the lock or inflamation. I am probably not saying it right, but it started to make sense to me.

I was told that horses with a shorter hip have more of a tendancy for stifle problems because of the angle of the leg. Longer hipped horses have less of a tendancy for stifle issues.

This is a prevalent issue in minis and I think we should all talk more about it. I believe there is a lot of unknowns and the vets are jumping to surgery too soon, for a quick fix. But of course, in some cases, that is possibly the only avenue of correction.

I am just beginning to learn about it and would hope anyone with experiences, good or bad, would be willing to share anything they have learned.
 
I have one I'm dealing with right now. He isn't terrible but his stifle pops especially working in tight circles or fast piviots. He is my show horse and he is only 2. I would like to avoid doing surgery on him but I'm looking into it. Stifles are so bad with these minis I'm tired of dealing with stifle issues with them. Yes it has to do with their hips, and angles of their legs. I asked about this not to long ago on here you can look it up. Minimor gave some good advice on legconformation with their stifles. Another thing I wanted to add and I did find some info on it is bad cowhocks can also come into play. Many of mine I've had stifle problems had bad cowhocks.
 
dragonfur said:
Have any of you had the stifle problems in any of your minis? What kind of treatment did they get, and did it work? What kind of surgery was used, if any was?
Thanks MinxiesMom for the vote of confidence! Dragonfur, you can check my history of posted topics for the long, detailed explanations but the short version is yes, both of my horses have this problem as well. My gelding had it very badly when I got him as a four year old stallion and caring for him was my introduction to the condition. I asked on here, talked to many different vets, followed all the instructions and tried just about everything but nothing helped him. I spent FOUR MORE YEARS avoiding the surgery because it scared me so bad to cut that ligament. I heard all kinds of horrible things about the arthritis it could cause, joint instability, etc., and frankly it scared the liver out of me since this gelding was my performance horse. What I didn't know at the time having never seen another horse with the problem was that Kody was not a typical case but rather one of the worst possible grades of this condition and there was no way exercise was ever going to help him. I finally tried the splitting procedure and it made things worse, which I didn't think was possible. Kody and I were both about ready to give up. His quality of life was awful and even his indomitable spirit was being broken by fighting this condition day in and day out. I was in tears every other day watching him sink into depression and stop trying. I finally called and scheduled the desmotomy (the ligament cutting) and have never looked back. He never locked another step!

Over the next few months Kody learned to play in his paddock, to walk back and forth to his water and food without thinking about whether walking was worth it, to back up and give his hind feet without fear, and eventually to kick at flies and now other horses. I almost cried the first time I saw him stomp at a fly without thinking about it. He actually startled himself!
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He no longer requires constant chiropractic adjustments and began to wear his hind feet evenly so the horse who couldn't go more than six weeks without seeing the farrier can now go 12 or more and still have good balanced feet. Watching the joy come back into his eyes was priceless and my only regret is that I didn't do it sooner. It was a miracle for us and any arthritis he might get is still better than what he was living with. I honestly think he's more likely to have gotten arthritis from all the wear and tear on the joint before the procedure than from having it done anyway.

My other horse is a colt I was given as a yearling because the owner knew I'd be a good home for a horse with a stifle condition. He'd been absolutely fine and then one day locked up a single hind leg in his stall and couldn't unlock it. Once he got it unlocked and got run around a bit he was better but would still catch on and off in that leg if left confined. I took him home, fed him up (he was a bit skinny from a growth spurt), gave him a large hilly turnout area and worked him over a few groundpoles and the locking went away almost completely. I was hoping he was over it but after three days in a stall at our last show as a two year old he finally locked up a bit again but it was mild and a little polework made it go away. This horse is such a difference case that I've hesitated to give him surgery for a variety of reasons. 1) Exercise does provide dramatic improvement in his case. 2) He's just a baby and still changing and growing. The condition might go away when he matures. 3) His quality of life is just fine at this point. He doesn't lock up in the paddock like Kody did, or even when backing or pivoting. I will continue to watch him for signs of trouble and will not mess around with other treatments but go straight to the desmotomy if I determine he requires some sort of intervention as an adult.

I've seen quite a few horses with this condition since having Kody's surgery done and there are definitely different levels of severity for locking stifles. Ones like Kody that lock and then release with a twang with almost every step are not going to be helped by anything short of surgery. A horse who locks very mildly and only when confined for long periods of time should probably be turned out instead of stalled and exercised frequently over poles at shows. Ones in between who don't lock all the time but can't get unlocked when they do may also be a good surgical candidate because they can really hurt themselves struggling with that permanently locked leg in the stall. Who wants to have to call a vet and use Ace and Bute every time they do that? It isn't really fair to the horse. Babies, if their quality of life is good, I tend to say "Wait." If they are miserable then get it done, geld them if it's a male, and disclose fully to whoever you eventually sell them to. Don't breed the parents again! I know totally post-legged horses who don't have a problem and horses who appear pretty angulated who do, so the conformational causes of locking stifles can be pretty subtle. IMO, having seen how horses with this condition suffer, it is absolutely inexcusable to breed an individual with locking stifles no matter how otherwise stellar they are. There is always a better horse out there somewhere who doesn't lock- breed to them instead. The offspring will thank you for it!

*rant warning*

I don't care if there's a five minute surgery that can make the horse normal, the fact is a problem like that would have gotten EATEN in the wild. We do our breed no service by knowingly perpetuating such a fatal flaw. Of course the individual horse can still be useful and loved after treatment, and should be, but they should not be bred.
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I am fairly rabid on this as you can tell; it is insanity IMO to consider an inability to walk normally without surgical intervention as a forgivable trait in breeding stock! Perhaps a horse who only does it mildly for a couple of months during a rump-high growing phase, but not one who does it regularly as an adult.

*now back to your regularly scheduled topic*
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As for the other surgeries and procedures, I honestly wouldn't even try them. The splitting has been a disaster for every horse I know who has undergone it and every single one of them ended up having the desmotomy in the end. Iodine injections might work on a very mild case but not for anyone else. Exercise is ALWAYS good but will only clear up the problem on certain mild cases. Try it anyway! That should always be your first line of defense. At worst your horse is stronger and better balanced when you're done.
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dragonfur said:
He says the horses with this surgery can still stand up to sleep, but with a bit more awareness, as the ligament that gets cut is the one that locks the stifle while they sleep standing.
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Yes, this is true. I was told they couldn't sleep standing any more and it's probably true that they can't do deep sleep, but my gelding still stands with a hip cocked snoozing in the sun despite having had both medial patellar ligaments cut. That surprised me but matched what I was told by other owners whose horses had had the procedure.

Minxiesmom said:
I have been told by a vet that on the young horses, if they get lots of hill work or long lining over trot poles (in a collected manner with hinds up underneath), it will help strengthen the stifle muscles and tighten the tendons and ligaments. Loose tendons/ligaments and poor muscling are allowing it to slip out of the groove at the end of the bone which causes the lock or inflamation. I am probably not saying it right, but it started to make sense to me.
I was told that horses with a shorter hip have more of a tendancy for stifle problems because of the angle of the leg. Longer hipped horses have less of a tendancy for stifle issues.
This is all correct and sounds well-spoken to me! Problems with bone formation (i.e. the bony groove itself) can cause the problem too, which is why the horse should be x-rayed before surgery is considered. An undermuscled horse (as in a young, weak horse who has been confined all its life with not enough protein) can also show this problem. You can also test blood for low selenium as that can contribute to tendon laxity and inappropriate patellar locking but in most cases that is not the cause of the problem. A well-conformed horse will not lock no matter how long they are stalled, starved, or denied enough selenium!

Leia
 
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Just FYI, but I realized after posting that your thread title was "Luxating Patellas" which is not the same as "locking stifles." Luxation is when the patella itself moves off to the side of the joint and the whole joint gets stuck. This is very, very bad and requires a vet immediately. "Upward Fixation of the Patella" or locking stifles is when the medial patellar ligament gets stuck over the bony hook the horse uses to sleep while standing and locks the leg in extension. Most times the horse can get this free themselves and there is no permanent damage except inflammation and soreness.

JMS Miniatures said:
I have one I'm dealing with right now. He isn't terrible but his stifle pops especially working in tight circles or fast piviots. He is my show horse and he is only 2.
I mean no offense here, but that's one reason you shouldn't be working a 2 year old on tight circles or fast pivots. It's very hard on their joints! I know two minis here on the forum in the last year alone who seemed absolutely fine but started having locking issues after being put into harness at 2.

JMS Miniatures said:
Another thing I wanted to add and I did find some info on it is bad cowhocks can also come into play. Many of mine I've had stifle problems had bad cowhocks.
I'm sure the conformation issues are related. Some of it is also postural. My guy does have cowhocks but it looks much worse than it is because when his stifles cause him pain he rotates them out, which rotates the hocks in. After his surgery he started to stand much straighter in the rear and didn't look nearly so bad.

Leia
 
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We have a couple unregistered boys that have locking stifles. It seems to help getting them back on their heels and off their toes. Just what we've observed with our boys.
 
I have one I'm dealing with right now. He isn't terrible but his stifle pops especially working in tight circles or fast piviots. He is my show horse and he is only 2. I would like to avoid doing surgery on him but I'm looking into it. Stifles are so bad with these minis I'm tired of dealing with stifle issues with them. Yes it has to do with their hips, and angles of their legs. I asked about this not to long ago on here you can look it up. Minimor gave some good advice on legconformation with their stifles. Another thing I wanted to add and I did find some info on it is bad cowhocks can also come into play. Many of mine I've had stifle problems had bad cowhocks.
My filly Sunrise Symphony did not have any (apparent) issues with her stifles until a farrier did a truly awful trim job on her. It caused her hind feet to toe out severely, which increased her hock angles, causing a bad cowhock stance. It was shortly after that trim that she first had the locking stifle. Even though the trim job was correctly a few weeks later (didn't have the money for a quick retrim, and the farrier was not available for a bit. (He's really a good farrier but was having serious personal problems--and physical ones, as well.)

The gelding started having issues at age 4, for no apparent reason. His conformation is not that bad; he's not cow-hocked or straight hocked. He may have had an injury in the pasture, but the problem has reoccurred on multiple occasions.

I also cannot work him in the round pen. Circles makes it much worse.
 
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I've seen quite a few horses with this condition since having Kody's surgery done and there are definitely different levels of severity for locking stifles. Ones like Kody that lock and then release with a twang with almost every step are not going to be helped by anything short of surgery. A horse who locks very mildly and only when confined for long periods of time should probably be turned out instead of stalled and exercised frequently over poles at shows. Ones in between who don't lock all the time but can't get unlocked when they do may also be a good surgical candidate because they can really hurt themselves struggling with that permanently locked leg in the stall. Who wants to have to call a vet and use Ace and Bute every time they do that? It isn't really fair to the horse. Babies, if their quality of life is good, I tend to say "Wait." If they are miserable then get it done, geld them if it's a male, and disclose fully to whoever you eventually sell them to. Don't breed the parents again! I know totally post-legged horses who don't have a problem and horses who appear pretty angulated who do, so the conformational causes of locking stifles can be pretty subtle. IMO, having seen how horses with this condition suffer, it is absolutely inexcusable to breed an individual with locking stifles no matter how otherwise stellar they are. There is always a better horse out there somewhere who doesn't lock- breed to them instead. The offspring will thank you for it!

I don't care if there's a five minute surgery that can make the horse normal, the fact is a problem like that would have gotten EATEN in the wild. We do our breed no service by knowingly perpetuating such a fatal flaw. Of course the individual horse can still be useful and loved after treatment, and should be, but they should not be bred.

Yes, this is true. I was told they couldn't sleep standing any more and it's probably true that they can't do deep sleep, but my gelding still stands with a hip cocked snoozing in the sun despite having had both medial patellar ligaments cut. That surprised me but matched what I was told by other owners whose horses had had the procedure.

Leia
Thank you for excellent information! Symphony, like Koda, is miserable when hers locks up. Mostly it's when she is in the pasture, lies down on the hard ground, then when she gets up, she's locking up every step.

She was at the far end of the pasture (which is not very big), when I went out one afternoon to give carrot coins to everyone. She tried to walk to me, but gave up about halfway across. The look on her face just about broke my heart. I went to her and helped her back to the barn and her stall (which is small, but has 8" of shavings--the deep padding seems to help more than anything), and OF COURSE, she got her carrots! She is very fine boned, long-legged and spare-muscled. Her muscle tone may very well not be good enough to keep the ligaments tight. I now have to decide whether to go ahead with her surgery, or wait and see if she'll get better with growth and conditioning, which my heart tells me likely will not. I can't bear to see too many more of her giving up incidents. She is the love of my life!

BTW: She is not going to be sold. She is not going to be bred. She IS, hopefully, going to be driven! The gelding was supposed to be my long-rein dressage horse, but his stifle problems have stopped his training cold. After surgery, we WILL continue. (What do you think about a 32" tall, sorrel & white pinto w/one blue eye, doing upper level dressage moves? lol)
 
It is not all that unusual to have a weanling or yearling that will have a stifle lock. Many times the young ones will outgrow it. Often their bones and tendons just do not grow at the same time and can result in a locked stifle.

Give your filly a chance to grow up, you might fine that she outgrows it. Do not do any surgery at this time.
 
Hi Leia - hope you and the boys are keeping well! Just wanted to compliment you on your post - well put, well written, clear and concise!

I would like to second and add to what you said in your second post - absolutely no round penning/lunging, any exercising to be in long straight lines maybe with some pole work included, slow work up and down hills, turnout as much as possible if not 24/7 and in an area that is large enough to give the animal room to have a decent straight line run at speed without coming up short against a fence, if they must be stalled or stabled for any amount of time then the space should be LARGE so the horse has room to walk round, not to pivot on it's hindlegs. Don't forget to keep those toes trimmed back, and last but certainly not least, give good food to help body and bones to mature and muscle to slowly build up!

Hope this makes sense - it is the middle of the night here and the dogs have just woken me up and I cant get back to sleep, so the little grey cells of my small brain aren't quite up to scratch yet. LOL!!

Good luck with your filly - I think I might be inclind to work with her and wait a while as she is very young and may just need to mature/develop a bit, but with your gelding - well he is probably not going to improve, so surgery might be your better option. But I would take on board what Leia has said and go straight for the full surgery with a good vet, rather than waste time and money on 'trying' other methods.

Anna
 
I just had the surgery done to sever those ligaments about two months ago, on a colt that was really struggling with it. He is 4 years old, and honestly, he is so relieved to be able to move freely again! He has learned that he can back up without having it lock and then pop. I can't imagine how yucky that would feel to them. I am very happy that I did the procedure. He was purchased as a breeding prospect as a weanling, but I gelded him as soon as the problem expressed itself. He is going to make a dynamite show gelding. I feel strongly that it is the right thing to do on a horse that has this chronic condition.
 
Anna, you're so funny! The boys and I are fine, thanks for asking. We miss you over there in Wales!

dragonfur said:
Thank you for excellent information! Symphony, like Koda, is miserable when hers locks up. ...
She was at the far end of the pasture (which is not very big), when I went out one afternoon to give carrot coins to everyone. She tried to walk to me, but gave up about halfway across. The look on her face just about broke my heart. I went to her and helped her back to the barn and her stall (which is small, but has 8" of shavings--the deep padding seems to help more than anything), and OF COURSE, she got her carrots! She is very fine boned, long-legged and spare-muscled. Her muscle tone may very well not be good enough to keep the ligaments tight. I now have to decide whether to go ahead with her surgery, or wait and see if she'll get better with growth and conditioning, which my heart tells me likely will not. I can't bear to see too many more of her giving up incidents. She is the love of my life!

BTW: She is not going to be sold. She is not going to be bred. She IS, hopefully, going to be driven!
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These horses need special owners like you who are dedicated to their best interests and love them enough to stick with them. Like any special-needs critter they will pay you back 100-fold.
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Listen to her and what she tells you about her quality of life but given your description, I think I'd try some regular in-hand pole work with her before jumping to surgery. It sounds like she's at her worst when she's cold and has been stationary for awhile, which is typical. They hunch over a bit and move stiffly, which makes them lock, which makes them hunch over even more the next time in anticipation, which makes it even more certain that they'll lock...it's a vicious cycle. The hardest part about working with a horse who locks is feeling like a bad guy for making them move when they're having problems but it's really the best thing you can do for her. Get her unlocked and moving forward and then don't let her stop for awhile! Take her for an immediate walk and keep her moving for maybe fifteen minutes or as long as you can and then walk her over a few poles. Encourage her to tuck her hindquarters under when going up or down hills or over poles and even do some lateral work if she's up to it. You want to warm up her muscles and get everything contracting so that when she eventually rests those muscles are a bit tighter and she's less likely to lock. Doing this regularly combined with keeping the hind toes squared off will help her even if it doesn't make the problem go away. Three times a day would not be too much! Besides, she'll love spending time with you.

My guess is she's better in a deeply-padded stall because she has to lift her legs high with each step which acts just like working over poles as far as helping her stifles.

For the gelding, yeah, I'd probably do the surgery and get it over with. Make sure both horses see a chiropractor at least once as locking horses often have lower back problems and continue to keep his hind toes lightly squared after the procedure as it will make it easier for him to relearn correct patterns of movement.

dragonfur said:
The gelding was supposed to be my long-rein dressage horse, but his stifle problems have stopped his training cold. After surgery, we WILL continue. (What do you think about a 32" tall, sorrel & white pinto w/one blue eye, doing upper level dressage moves? lol)
No sillier than the fact Kody is supposed to be mine!
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Since he was forced to retire from combined driving events because of his back injury he's learned to do leg-yield, shoulder-in, haunches in, and we're now working on Spanish Walk and eventually half-passing...all in-hand.
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We were working up to Intermediate level driven dressage before he got hurt.

Love the haiku in your signature, by the way!

Leia
 
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Thanks to everyone for your invaluable input! I have decided to hold off on surgery for Symphony unless the stifle locks up to where she cannot unlock it (doesn't seem to be a threat at this time).

The 8 YO gelding will likely get the surgery by the end of this year, as he was 5 when his occurred, (due to an attack by a donkey I no longer own), and is recurrent. He may get to be a long-rein dressage horse yet!
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Y'all helped me make that decision, and I will begin exercises with her (although there are no hills around here). I think a program of gradually increasing walking/trotting/backing, but no roundpenning, might help improve her muscle tone. Hopefully that will be enough to solve the problem. (If not, after having the necessary surgery, she'll have good hindquarter strength for driving, and a really good backup! Oh, and I'll be in better shape, too!)
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BTW: Leia, the haiku (thank you!) is in honor of another little gelding, Spirit, who I got after he was abused by a professional ruiner, er, trainer, and was absolutely terrified of plastic grocery bags and shavings bags, especially white ones
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. Clicker training has worked wonders with him, but I don't know if he'll ever be mentally sound enough to drive. (Has a beautiful action, but is really quick to use those hind feet if he gets scared. Can't afford a new cart if he were to destroy my current one!) But, ya just never know! I'll give up on him when one of us stops breathing.
 
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Just a little differant view here. I have had three horses with stifle issues over the years, 2 rescues and one I bought knowing he had this problem. One of the rescues was very severe and had infact been locked up for yrs unable to use that leg properly. This guy I took atraight to the vet from the place I found him and had the surgery done on the way home. I tell you I cried 2 weeks later when this boy trotted freely for the first time then gave a little buck for good measure...you could just see the joy on his face! The second rescue locked in both stifles. Tried the splitting procedure first, worked on one stifle however had to cut the other stifle in the end as improvement was only slight on that side.

The third horse was younger and had been kept in a large pasture all his life. Did the splitting procedure on him and it correctd him 100%. Went on to be a great (though HOT) little driving gelding with no further issues.

I think both procedures should be looked at with the advise of a knowledgable vet. It have seen both work and the splitting procedure was none invasive with zero recovery time...no incision, no stitches. I guess in anything but a severe case I would go that way first then follow up with the surgery if the splitting waas not successful.
 
dragonfur said:
I think a program of gradually increasing walking/trotting/backing, but no roundpenning, might help improve her muscle tone. Hopefully that will be enough to solve the problem. (If not, after having the necessary surgery, she'll have good hindquarter strength for driving, and a really good backup!
Be careful with the backing. It's very, very difficult for a horse who locks, usually makes them lock, and since they can't do it correctly it really doesn't build the right muscles anyway. That is the LAST thing I'd be doing with her. If you live somewhere flat you can even get a few loads of sand or fill dirt brought in and create your own little hill like motocross people do. I find that works very well!

stormy said:
I have seen both work and the splitting procedure was non-invasive with zero recovery time...no incision, no stitches.
How is that possible? They cannot split the ligament without making an incision for the scalpel to go through so it can cut the ligament. My horse had two incisions, several stitches on each leg and a very long, very difficult recovery involving much stall rest at my vet's insistence.

Leia
 
The splitting procedure is done with a hypodermic needle inserted through the skin, the ligament is split with the needle, no incision, only a little local anesthesia. It works, have seen it on one of mine and one of a friends horses.
 
Hmm, sounds like there's either more than one type of splitting procedure or more than one way of doing it. My vet did not offer that as an option; the only thing involving a needle they had available was injecting an irritant to produce scarring. Everything I read on the splitting procedure described it as using a scalpel to make three to six vertical slits with the grain of the muscle to cause scarring and thickening.

Leia
 
My understanding at the time was that it was a fairly new procedure but it worked almost immediately. He did insert the needle more than once and would split the ligament in an up and down motion just moving the needle with the skin.

I have seen what you are talking about also, a small incision with a couple stitches afterwards.
 
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