Tuesday, November 22, 2011

Does Lilly Have UFP?

After reading all the comments on my last post, I think everyone is right with their diagnosis of Upward Fixation of the Patella (UFP). I had the same suspicions, and after doing some more research and watching a lot of videos on YouTube, I'm even more sure.

If you're not familiar with UFP, here's an explanation from SmartPak that describes it very well:

The patella is the small, bony plate (the kneecap) that protects the knee joint in people, where the femur and tibia meet. In horses, this joint is known as the stifle. A unique hooking of the patellar ligaments over a notch on the femur allows the horse to lock its hind legs in the standing position. Unfortunately, if one of these ligaments remains in the hooked position, the horse is unable to bend its hind legs. This condition is known as Upward Fixation of the Patella and can range from a slight delay in a leg's forward motion to completely locking that freezes a leg for long periods of time.

From what I read, this condition can have quite a few causes:

  • Conformation-excessively straight hind legs
  • Lack of fitness
  • Negative plantar angles
  • Excessive ligament length

You know, people ask me all the time if I've ever thought about breeding Lilly... here's just one more reason why I might laugh out loud when they ask! She's built pretty downhill, which seems to be a factor with UFP, and she's also sporting hind legs that are slightly straight. I've definitely seen worse, but it's there.

Legs a little too straight...
Lack of Fitness
She's been on 24/7 turnout since the middle of August when her shoes came off, but she hadn't been in consistent work until the middle of October when we started an exercise plan. With her thin soles and sore feet, I'm not sure she's getting much exercise on her own, though. Part of our exercise plan incorporates backing over poles, backing up small inclines, and leg lifts, all which are supposed to help strengthen the stifle. The Equine Fitness book I have includes some great exercises for this specific purpose, and we're doing them every time we ride.

Negative Plantar Angles
I'll have to inspect her hind hooves more closely, but nothing has changed on her hind hooves. There's all kinds of things going on with the front hooves, but we barely touch the hind hooves when my trimmer comes out.

Excessive Ligament Length
I'm still trying to find out more information about this one, but I'm assuming it means just what it says... and it makes me think back to Lilly's stall door accident. Is it possible that her injury stretched the ligament, making it more difficult to release? I mentioned a while back that I noticed Lilly was resting her hind legs more than she used to. I attributed it to removal of her shoes, thinking she was just more comfortable, but maybe it has something to do with this instead.

The Atlanta Equine Clinic (thanks, Terry!) has a fantastic article on UFP and you can find that article here. After reading it several times, a few of the UFP clinical signs caught my eye:

- The horse will frequently drag the toe of the affected limb(s) during exercise - Every time my trimmer comes out, she makes the comment, "She really drags her toes, doesn't she?"

- The horse will resist the canter. Resistance may be most noticeable during the transition between the trot and canter, when the horse is forced to extend the pelvic limb for a prolonged period - How many posts have I done on this? I've lost track!

- The canter is very rough or "bouncy". This occurs as a result of consistent delay in pelvic limb flexion from the extended position - I was just commenting in the last post how her clockwise canter feels very rough. Almost like she's cross-cantering.

- As with many cases of pelvic limb lameness, secondary abnormalities such as thoracolumbar ebaxial (back) and proximal thoracic suspensory ligament soreness are also present - Back soreness? Ligament soreness? Those are two main themes with this blog.

Assuming UFP is what she has, I'm really curious as to why it has suddenly become so much worse. I've been seeing this in her for years but it was such a rare occurrence I didn't investigate too thoroughly other than having the vet/chiropractor out. Lately, it's been happening once every 2 weeks-ish and at the show on Saturday it was happening over and over again. Perhaps she was a bit fatigued, thus making it worse, but she really wasn't ridden very hard at all. Each class lasted about 5 minutes and only one of them involved cantering. I was really bothered by how often it was occurring.

If it's simply a strength issue, and exercise is the usual treatment, why does it seem like the more I strengthen, the worse she gets? Looks like another call to the vet is in order.

And you know, on top of this issue, we're back to the diarrhea again... she was covered in it when I went to visit her today. Way more information than you want to know can be found in this post, if you're curious about the history.


  1. Sometimes locking stifles - particularly on only one side - and toe dragging behind can be sypmtoms of EPM, particularly if the symptoms are getting worse. Not trying to be alarmist, but those were part of Drifter's symptoms. The new ELISA peptide test is not that expensive, and could definitively rule out EPM, or if she had it, treatment under the new protocol (not Marquis) is not that expensive. There are some older tests that are not that accurate - the new test offered by Dr. Ellison is accurate for the strains affecting horses. Many vets don't know about the new test and treatment protocol - more info on my EPM page.

  2. I've seen a lot of horses who end up with locking stifles following injuries at the track. The good news is that a lot of them resolve on their own with gradual fitness building. The ligaments often tighten back up and the muscles support the joint. I hope that's the case for you!

  3. I have been considering the same thing for my Milo. As long as I have had him he occassionally feels like a sort of "trip" on the back end where he almost feels like he couldnt bring the leg forward (usually the right hind actually), but it is inconsisitent -maybe once every two weeks, somtimes more, sometimes less. I should probably look into this as well being as he is halter built and conformationally downhill. He is reluctant into the lope and more often than not feels like two men in a horse suit. One direction is always better than the other. I never considered it enough because it has been so inconsistent. But Im on board with you now- I think I should. I have one video from last winter's shows that sort of shows the "mis-step" at the end of the pattern.

  4. I'm sure you've read up on why horses have diarrhea, but I found a nice reference here: http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/22202.htm

    A couple of things spring to mind: Did the hay at your barn change? Did she drink different water at the show? Is there a chance she has mild ulcers that were exacerbated by the "stress" of showing?

    It might help to give her aloe juice (in case it's ulcers) or probiotics (in case she ate something that is bothering her tummy) or both. My retired guy gets loose stool frequently, and it seems to be related to such "minor" events as having all his buddies leave the barn without him, or starting a new batch of alfalfa, or adding/removing salt to his ration. He ALWAYS got loose stool at shows when we competed, but I was told it was "no big deal" and at that point in my life I didn't really question it. Probably he had ulcers at the time... hind sight is 20/20 and all.

    Oh one more thought - I know a horse that drank from a pond and picked up Giardia. He ended up with diarrhea, but that was cleared up by a dose of antibiotics.

    (Yeah, I'm just throwing out ideas to see what sticks. Helpful, eh? Haha!)

  5. Kate, I did read that UFP can be mistaken for EPM and vice versa. It looks like a lot of the symptoms are similar and I'll definitely check into it, especially since her symptoms seem to be getting worse. Hopefully my vet will have some ideas. Thank you!

    Dom, thanks! I'm hoping that's the situation with Lilly too. I'm just worried about her because when we were doing less work, she seemed to have fewer issues.

    It sounds like Milo might be experiencing the same thing as Lilly. When it was happening every once in a while, I wasn't too concerned, but that's changed now. I would love to see the video of Milo you're referring to.

    Jen, thank you for all the ideas! Lilly has been having this problem on and off now for years. My vet and I ran every test we could think of and never found anything to be "wrong". She wasn't becoming dehydrated either, so other than the inconvenience of having to scrub her rear end every day, there wasn't a big concern.

    I can't seem to find any events that correlate with the onset either. She was a bit runny even before the show, so I think it was starting to come on a couple days ago. It happens all different times of year, at different barns, when nothing changes, and when things do change. I just can't find the source and nothing seems to help.

    She's been on probiotics for quite some time, but I've never tried the aloe juice. It's just very frustrating...

  6. Well, the pretty girl likes to keep you educated, doesn't she? :) I hope this is a blessing in disguise for you two, and that this is something that can be resolved through targeted exercises or something like that. You guys look just awesome in your show pictures, btw...I really love her relaxed trot under saddle. What a great team!

  7. Some horses have a digestive problem with one element of their feed - we use cocosoya oil at our barn, in relatively small quantities, but we had one horse who would have diarrhea if any oil was in his food - otherwise he was fine. You may have to carefully eliminate each element of feed and supplements to determine if there's one thing that's causing her a problem.

  8. Thanks, Sarah! I hope this is something that has an easy solution, or I would even be ok if it just went away on its own! :)

    Kate, unfortunately (or fortunately), Lilly isn't on any feed at all. She's on a vitamin supplement, hay, and pasture, and that's it.

  9. Oh Lilly! You are making your mama nuts! Give her a break, why don't cha?

  10. I read this whole thing. Definitely rule out EPM... I've been following Kate and it is scary! My QH is built slightly down hill, but so far so good. I hope this is all behind you soon - and really, thanks for sharing and educating me.