# Sacroiliac disease- explanation and advice please



## dozzie (27 May 2007)

My horse has been diagnosed with sacroiliac disease. I have trawled the internet and cant find out much about it. I have been told by vet it is crystallisation around the sacroiliac joint.

1. What are the crystals formed from?

2.How is it caused? I am not aware of a trauma injury but she has had a foal.

3. Is it hereditary? I have found out it is not thought to be linked to conformation!

Has anyone had success in managing or improving a horse with the disease and if so how?

Just trying to find out about possible options! She has had cortisone injected into the joint which has definitely had some impact but how long will it last? I just dont want to keep pestering the vet!! Also like to see things in writing (visual memory thing!!!)

I am presuming it is some sort of arthritic complaint. Am I on the right lines?

Have had some help from a few kind people on here but have not posted about the disease itself so hope this doesnt offend those people. Your advice is stored away!!


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## eventing_chick (27 May 2007)

Many horses can carry on with slight lameness if kept fit.
I belive it is not heretitary.
I had a horse with it we rested him for 8 month and he showed no improvement.Gave him a whole year and eventually gave up and sent him to the blood bank, he was only 6.
Sorry thats not very possitive


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## Oldred (27 May 2007)

Sorry, I don't have anything helpful for you but I was wondering what your horse's symptoms had been to get the diagnosis? I think my horse may have this but extensive veterinary tests have come up with nothing!

The only doomy advice I have had regarding sacroliliac disease is that if rest doesn't fix it there's nothing else that can be done. I have a retired 7 year old mare who has only been lightly backed and also had no known injury but repeated attempts to work her result in lameness, pain, crookedness, unwillingness to trot or canter. Nerve blocks to her sacroiliac area resulted in 100% improvement but cortosoid injections were not recommended because of laminitis.


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## dozzie (27 May 2007)

Was going to pm you as I didnt want to worry people but decided it was best for people to know.

Where do I start with symptoms?!?

These are the ones my horse had shown to some degree. TBH I thought she was being lazy/naughty!

Bucking broncos, inabillity to track up, unwillingness to go forward from the leg, spookiness, unwillingness to bend (on one or both sides), saddle fitting issues, unwillingness to load, unwillingness to go downhill plus any kissing spine sort of symptons!! Upward transitions are difficult as horse cannot engage the hocks properly and horse often changes leg in canter going disunited. Also unwillingness to lift through the back. They can also be unwilling to lift one or both hind legs when picking out feet but wont necessarily fail a flexion test!
Lack of straightness...I keep thinking of more!!

Most of my problems occur in the school and could have been put down to schooling/temperament issues.

Difficult to diagnose without bone scans (scintilligraphy).

Most horses with SI disease are often considered lazy and unwilling to work. They may or may not be lame.

It often goes undiagnosed unless in a competition horse but I think that a lot of horses may just be sold into less competitive homes because they dont have the potential to go further.

My horse is not lame and will jump but some will struggle with jumping and flatten rather than bascule and some buck on landing (probably several bucks not just one). They also find it hard to engage the hocks in canter so lose impulsion to leave the ground.

I think it is more commonly diagnosed now due to more vets having scanners available. It costs about £1500-£2000  to have the scans done which is possibly why vets do it as a last resort or when horses are valuable/insured. 

My vet couldnt find anything and suggested physio. The physio picked up the sacroiliac problem and bone scans confirmed it. So maybe its worth you getting a physio out!!

I hope it is not SI disease but could be something similar.


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## sikaran (27 May 2007)

Sorry don't have good news either.  My mare (9yo) was diagnosed and did not improve after 6 months rest + 3 months walking in straight lines.  She's now at the blood bank.
Sorry.


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## mickey (27 May 2007)

My horse has a spavin and was diagnosed with sacroiliac 'strain' a few yrs back. The vets prescribed box rest. I ignored them and turned him away to pasture for 9-12 months. Then brought him back into work very slowly over months with physio. Have had no problems with it since then.

At the time he was diagnosed I was given very little info about SI strain (Indeed, I think the vets knew every little about it).

He was diagnosed using scintigraphy.

I guess how the horse responds depends on the severity of the SI problem and giving it the best poss chance with the right progressive work after a period of rest.


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## dozzie (27 May 2007)

I think you are right about the progressive work. My gut feeling is this is the right way forward with my horse as it has been shown to work with her before. As you say I dont think enough is known about it yet. My vets have suggested working her as she is not lame but no hill work- guess what I live on a hill!!!


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## nelliefinellie (27 May 2007)

I have a horse with chronic SI disease, also impinging spines and collateral ligament desmomy in both front feet. He was box rested for 6 months for the feet which made the SI worse. Main symptoms were crookedness, working on forehand,tail swishing, buckingI had loss of use for him (he ws insured for eventing). Was advised to retire him as light hack bit decided to give it a shot to get him back into work. He had steroid / sarapin injections, remedial shoeing, loads of physio and rehab and is on MSM, cortavet and various other supplements. I find that keeping him fit and keeping his weight down is key. He lives out as much as possible on starvation paddock. I only work him on good surfaces, no jumping, some hacking, lots of working round and deep. He does loads of work on the pessoa  and over poles. He does sart off a bit stiff some days , and still tends to go on forehand  and quarters in in canter, but is basically sound, and successfully competing affil dressage (won an elementary last week  
	
	
		
		
	


	




 ).  Good luck!


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## dixie (27 May 2007)

Mine was diagnosed with this on Friday too, after the bone scan together with DJD in his fetlocks - he is only 7! 
	
	
		
		
	


	





I've been told to rest him for 3 weeks whilst the injection helps the fetlock joint and then the physio is coming out to work out a work programme with him on a pessoa. I'm led to believe that this type of work should help him a lot and that some horses come right and with some it niggles on forever - a bit like troublesome backs in humans.

I was also told that the SI was more like a fibrous tissue ie like a tendon injury.  The vet is going to give me a report on his findings which I am hoping will be useful as I had a lot of information to take in on Friday.

There is an article on Horse and Hound that was useful, I'll try to find it for you again.

Here it is :-
http://www.horseandhound.co.uk/horsecare/1370/55632.html

Best of luck


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## mickey (27 May 2007)

Yes, I do feel that being careful with the work will be invaluable, esp for the next 6-9 months. And you don't want your horse galloping/tearing around the paddock and twisting if you can help it (I know it is tricky to contain their movements) 
	
	
		
		
	


	




As your vets are happy for your horse to work it makes me think that it is maybe not as severe as it could be (either that or it is under control with the treatment that has been given).
My exp is that it is wise to push vets for as much info as you can, get them to talk you through the scans etc. Unfortunately I do think this is one of those things that little is known about....
Best of luck. Take it sensibly and you may well be surprised. Suggest as well as a really decent physio trying a glucosamine.chondroitin.HA supplement. I use Extraflex HA.
www.feedmark.com.


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## dozzie (28 May 2007)

Thanks for that. My mare definitely is better when worked hard and goes completely backwards when not worked for any length of time. And I find she is better off out as much as possible. 

My vet hasnt said anything about remedial shoeing but my farrier is going to look into it! I was thinking about a pessoa so its good to hear that it works. It seems to be the horses that follow a good physio and work programme have the best chance. Ive been in touch with my old instructor who is very willing to come out to help so thats a good start!


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## dozzie (28 May 2007)

Thanks Mickey. TBH the vet gave her the all clear the week before and it was the physio who picked it up so I dont think its that bad. I just feel Im into damage limitation now!! I have had such bad experiences with horses put on box rest and like you I would rather have her in the field walking at her leisure, she is pretty good and doesnt hoolie unless shes been in a box for a few days!! Hence I try to keep her out as much as possible.

The vet has suggested that she will just be a happy hacker but I know from last summer when I had some lessons at Catherston and ended the season doing an excellent dressage test that she can do more than hack! 

Ive also received differing opinions about physio. The physio is very positive and says she can help. The vet at the clinic she was referred to said physio would be good but my own vet said it couldnt help!!! GRRRR!!!! As Im insured for physio I cant see why we cant try it!

I have been thinking about supplements too but cant do anything until the vet reassesses her in a few weeks to see if the steroid injection has worked. He may suggest physio then!


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## mickey (28 May 2007)

I think the reason vets are reluctant about physio is that the SI area is very hard to get to - Located very deep inside the horse so hard to manipulate. Ask your physio, but I think even if they can't get to the SI they can adjust the muscles around the area which should help things along and prevent other issues from emerging related to the SI.

My horse was also written off as a hack, he is now competing dressage and showing with a lot of success.

I agree that if you leave a horse on box rest and it either a/gets itself so wound up it is pacing or going mentally insane and/or b/goes ballistic when it is eventually turned out, it may be better just to leave it out in the first place. That's what I did. 

If you are sensible and go with what you think is right I am sure you will help your horse on the road to recovery. Good luck.


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## debradley (29 May 2007)

Hi yah.  Well as you thought, it looks like you're in for a lot of hard work to keep her fit.  Was just wondering, once Honey's had her back op I'm going to put her onto a glucosamine supplement as I know it's very good for helping to repair ligament and cartlidge damage; was just wondering if your mare would benefit from this too?  Sorry if i'm stating the obvious and it's something she's already on  (apparently it takes about 6 weeks to see any improvement once they're on this) and I'll ask Svend for you next week and let you know as soon as.


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## dozzie (29 May 2007)

Cheers! D! 

She is not on anything yet as dont want to mess up the cortisone/oid test! But from what I can see physio and a really thorough exercise programme is the way forward! Plus a supplement. Or supplements!!!! She might need a bit of acupuncture too!!! Would love to know what Svend recommends! Thanks. Good luck with Honey! 
	
	
		
		
	


	





Just need my OH to say I can give up work so I can ride my horse!!!!  
	
	
		
		
	


	





BTW Horses can talk: we just need to be better at listening... I so agree!!!!


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## DollyPentreath (30 May 2007)

Mickey, so thrilled to read your post especially as my Shaab mare was diagnosed with SI strain about 6 months ago, aged 10. She was treated extensively with steroids, shockwave and Tildren all with no avail. 
	
	
		
		
	


	




 Her only symptom was changing behind in canter and her sacroiliac was confirmed as the problem area by nerve block and bone scan. She's now having over a year off and being put into foal (with the recommendation of my vet, plus she's the nicest, incredibly talented little horse! (Iam biased..)) with the hope she might come back into work sound. I thought there was pretty much no hope of her coming back sound, but your post is really encouraging. Even if I can't have my event horse back it would be lovely to be able to hack or do some dressage. Thank you for making my day! 
	
	
		
		
	


	













Dozziesmummy, all the best with your horse, obviously treatment didn't help with my mare, but I really hope something works for you!


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## Twilight (30 May 2007)

My horse was diagnosed with SI 3 years ago as a 5yo.  When I tried to find out about it at the time every one was quite negative so it is nice to see some positive comments here.

  The vet gave him fitness work which improved him, but he still wasn't right.  Eventually I turned to my Chiro and a Physio.  Over a period of months she really helped him.  She gave me a series of hind leg exercises, circling them.  I have been doing them for 18 months now.  He is still regularly seen by the physio and is doing everything I want including starting out cross country.  He has been seen by the physio since doing his first one day and she says he looks perfect!  I really recommend the leg stretches as they help you feel how tight the pelvis feels and also helps the mobility of the pelvis.  Physio, pole work and stretches has really helped.  Good Luck


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## lahora14 (30 May 2007)

My mare was diagnosed with SI disease last year-she actually dropped to the ground when you pinched it. She is having a bone scan next week but i am not hopeful as she has lumbar pain aswell.

My physio gave me 2 exercises to do. One where you group you fingers together and run them under the horse's belly firmly to get them to round their back and one where you run your hands firmly down either side about a hands width away from the horse's tail. 

My physio recommended using a Pessoa but my vet said not to use it as it puts a lot of strain on the SI.


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## dozzie (30 May 2007)

Thanx Twilight! Thats very encouraging! I definitely think there is an improvement in my girl since having the steroid injection. She just seems so much more willing to move forward. It certainly hasnt completely cured the problem and it may be just the bute but I really do think she is a bit happier. Shes even trying to stretch down  now which is a good sign I feel. I think providing I can keep her sound I can work around the problem. She is such a lovely person that I really feel she is worth fighting for!


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## dozzie (30 May 2007)

Hi Lahora

So sorry to hear you are in a worse position than me. I hope you find a way to help your horse and perhaps this post has helped you in some way to think about other possibilities. It has certainly helped me. 

TBH I dont have a lot of faith in the medical profession so perhaps I am biassed. It is so much luck of the draw as to whether you get the right/best advice so by pooling info in this way we can all be better informed.


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## Maz55 (5 September 2013)

Hi nelliefinellie I don't even know if you'll get this now but it's worth a shot! My horse also has impinging spines and chronic SI problems and I was also told to retire her which I'm ignoring but at a loss to know where to go next. I'd love to know more about the remedial shoeing and the rehab you did... Thanks


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## Maz55 (5 September 2013)

Twilight could you describe the stretches please?


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## gunnergundog (5 September 2013)

dozzie said:



			1. What are the crystals formed from? Calcium deposits

2.How is it caused? I am not aware of a trauma injury but she has had a foal.  Trauma:  the stallion mounting her, getting cast, arsing about in the field etc etc

3. Is it hereditary? I have found out it is not thought to be linked to conformation!  Imo no.

Has anyone had success in managing or improving a horse with the disease and if so how?  Yes....see below

Just trying to find out about possible options! She has had cortisone injected into the joint which has definitely had some impact but how long will it last? How long is a piece of string...each case is individual.


I am presuming it is some sort of arthritic complaint. Am I on the right lines? Yes
		
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Get a good chartered physio on board and work on building the strength in the muscles surrounding the pelvis, also the SI ligament itself.  Depending on your own skill as a rider, you may want to look at someone to help you who has good feel and can influence the horse sufficiently to use itself appropriately.  In days of yore I would have recommended Jo Hodges, when she was at Milton Keynes, nowadays.......???


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## cobwithattitude (6 September 2013)

My horse has had 2 courses of steroid injections in SJ area and I was told never to give her any longer than a couple of days off; not to lunge her in warm her up well, avoid deep going; avoid lunging and use pole work to build up muscles - she injured her back, we think, falling over, so may be a little different from SJ disease.  She is now doing novice aff dressage and is just about to start jumping again (I am the prob here, not her!)  I am paranoid now tho, and regularly feel her back, run her up (she showed signs by dragging hind foot) She also had remedial shoeing - with heels on her hind shoes for 6 months.  Hope this helps.


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## peanut (6 September 2013)

Gosh this thread is 6 years old!

What is the difference between sacro-iliac disease and sacro-iliac dysfunction?


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## cobwithattitude (7 September 2013)

Well spotted, Nancie.....so intent on putting my bit that I failed t note. .....


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## Maz55 (11 September 2013)

Thanks. Unfortunately injection in the SIJs didn't work for my horse : ( I'm toying with the idea of having them done again but this time combining with injections in spine, but as insurance ran out a long time ago it's a big cost...
My girl is barefoot - i've not been given any advice about remedial shoeing cobwithattitude was that advice from your farrier or vet and what is the purpose of it?


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## applecart14 (11 September 2013)

Oldred said:



			but cortosoid injections were not recommended because of laminitis.
		
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What???? Surely you just restrict the horses diet for a couple of days, keep in off the field and on box rest and stop giving it mints???  I've never heard of this before.

My vet thought my horse had this a few weeks ago, but my physio did some LW ultrasound over the area and when he saw the vet the following week the vet said he was much better so just ruled it out (as if it had never been mentioned and as if my heart hadn't stopped when he'd first mentioned it.)  I must say I have found this a lot with vets previous to this practice - they were always doom, gloom, and worst case scenario and then a week or so later its as if what they have said has been ironed over or simply forgotten about.


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## applecart14 (11 September 2013)

Maz55 said:



			My girl is barefoot - i've not been given any advice about remedial shoeing cobwithattitude was that advice from your farrier or vet and what is the purpose of it?
		
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I think remedial shoeing works because it basically alters the way a leg moves or how a foot falls so that the horse moves in a different way thus taking the weight off the injured area and allowing it to heal.

That is my interpretation.  You can increase the length of a foot by adding lateral extensions and giving more support to the heel, or put wedges between the foot and shoe to increase height, which will make the limb move differently.  Even simply squaring the toe with a rasp can alter the 'foot flight' and have a drastic affect on how a horse moves.

Bit like when you add orthotics to shoes to stop your feet from hurting (see link to human orthotics)http://www.physioroom.com/catalog/Orthotics_Arch_Supports/2982.html


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