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HELP! Mare with Obturator Nerve Paralysis

Equine-Reproduction.com Bulletin Board » Foaling and Immediate Post-foaling Issues » HELP! Mare with Obturator Nerve Paralysis « Previous Next »


Author Message
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 33
Registered: 10-2005
Posted on Sunday, April 05, 2009 - 11:03 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Has anyone experienced obturator nerve paralysis in their mare(s) after foaling?

Our mare foaled early Wednesday morning and has been unable to get up since. The foal first tried to come out all four hooves and nose first. We got her hind hooves back over the pelvic rim and then she must have hooked one back up and was hopelessly wedged. My mare has the foal stuck like that for a little over an hour. We lost the filly and the vet says my mare has obturator nerve paralysis in in right hind leg.

Once a day since Thursday we've been getting a group of men together to get her on her feet. She needs help getting her back legs under her but she's standing square, she'll bear weight on the right hind leg and stand on her own. The first day she was only up 1 hr 40 minutes. Friday she was up 7 hrs. Yesterday she was up 9.5 hrs. She seems stronger in that leg and would actually lift it up and flex it but she still cannot take a step with it.

Has anyone else has this problem? The way our barn is constructed, we would need to do some major reinforcing to make it strong enough for a sling. So far we've only been able to locate a cattle sling - none for horses around here.

We're taking it one day at a time. She's eating, drinking, going to the bathroom, and is very bright-eyed. I'm just wondering at what point down the road, if she still can't stand, on her own, will we know if she will be able to walk again or if the damage is premanent.
 

Kathee McGuire
Breeding Stock
Username: Katheekj

Post Number: 751
Registered: 12-2005
Posted on Sunday, April 05, 2009 - 11:39 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

So sorry for your loss, what a horrbile ordeal. My prayers are with you. I wish I had something more to offer.
 

Linda Bauer --Rebel foaled day 333
Breeding Stock
Username: Llazyt

Post Number: 258
Registered: 04-2007
Posted on Sunday, April 05, 2009 - 01:24 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

I just want to say I am sorry for your loss and hope your mare gets better.
 

Ad TB
Breeding Stock
Username: Ajvtbs

Post Number: 230
Registered: 01-2009
Posted on Sunday, April 05, 2009 - 07:10 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Susannah, I'm a human physiotherapist (physical therapist) and I've also done a masters in veterinary physiotherapy. Firstly I'm terribly sorry you lost the foal. Personally I haven't seen a horse with obturator nerve paralysis but I have seen videos of it and studied it. The obturator nerve supplies the adductor muscles of the thigh. These group of muscles lie on the inside of the thigh. These are the muscles that prevent the leg from sliding out when walking or standing. The nerve can be damaged or compressed during foaling. The severity of injury varies, including standing and walking with the leg abducted (with the leg out to the side). Circumduction (circling the leg) when walking. Instead of moving the leg straight forward the horse will rotate it or bring it out to the side. The most severe injury is when the nerve is completly paralysed. If the nerve is completly paralysed treatment is aimed at reducing inflammation in the nerve, stall confinment with a non slip floor and non slip bedding. Support with a sling if the horse can't get up form standing.
Is it one leg or both? I've read that recovery is good in most cases and the best thing is to try and get the mare to stand for as long as possible with or without the aid of a sling.
Manual feedback to 'kick start' the nerve by using hot and cold packs to the inner muscles of the thigh. Rubbing and stroking the inner muscles of the thigh. Electrical muscle stimulation of the thigh muscles can also be benificial.
I hope this helps a little, have you any picures of the mare so that I could see how she is standing? Keep us updated
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 34
Registered: 10-2005
Posted on Sunday, April 05, 2009 - 08:32 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Hello,

It seems to be just her right hind leg and the nerve is paralyzed. She can't get up on her own and can't walk.

I don't think a sling is an option for us. Our polebarn is a little rough around the edges and we'd need to do some major reinforcing to create a structure to support a sling.

With the help of several people we were able to get her up and standing around 1:00pm today. While she was up we had our chiropractor check her out and he was able to adjust her. It looked like the area he 'cracked' was right above her hips. She lost her balance around 3:30, we couldn't get her leg back under her in time and she's been down since. After an hour we tried a few more times and even had several men from the local volunteer fire department there to help for the last two attempts and she wouldn't even try. Tomorrow we will try again.

Another of our concerns is rolling her over onto her right side as she's been spending alot of time on her left side and is starting to develop sores. She let us roll her over once earlier but was not cooperative this evening. I think she is just plain exhausted.

As far as bedding, we've been using straw to help pad her pressure points plus she has a lot of healing to do in her 'girl parts' and I was worried that sawdust would stick to her and cause more irritation.

Yesterday we used a big eletric massager on her but not so much in the inner thigh. Today I spent a lot of time massaging her thigh by hand. I will start the hot/cold therapy tonight.

For an obturator paralysis case, what is the time frame for recovery? Today is the 4th full day.
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 35
Registered: 10-2005
Posted on Sunday, April 05, 2009 - 08:36 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

We've been trying to keep an eye on the color of her urine. Yesterday she did not pee while we had her standing. Today she did finally pee and we got a sample. It looks like cloudy apple cider. Is this something to be concerned about? She does have some tearing/bruising going on back there.
 

Ad TB
Breeding Stock
Username: Ajvtbs

Post Number: 242
Registered: 01-2009
Posted on Sunday, April 05, 2009 - 09:01 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Unfortunately I don't believe there is any chiropractic technique that will help the nerve paralysis. If there was nerve impingement maybe but not when the nerve is inflammed also chiropractic techniques are contraindicated after foaling as the ligaments of the pelvis are lax and therefore can be dangerous as too much movement can result. Straw is probably the best bedding as it provides the best cushioning. Allow the straw to get a little dirty so it compacts and is firmer under her feet, fresh straw on top but not against the ground as it can be slippy. Recovery time is usually a few weeks but you should see some kind of return in muscle function within 10 days. It's common that the muscles in the inner thigh will waste, this can be very rapid it's called neurogentic atrophy. Directly stimulating the muscle with a electrical stimulating machine can help reduce the wasting (atrophy). The obturator nerve only innervates/acts on the inner thigh muscles so the other muscles of the leg should be unaffected unless there is also damage to the sciatic nerve. I know it's tough but I had a mare with a spinal cord injury a few months ago and she had complete paralysis of one hind leg and one front leg. She couldn't get up herself or lie down without falling over. She made a good recovery although she will never be perfect. On the colour of the urine, she might be dehydrated especially if she's lying down and not drinking as much as she should. Maybe you could give her some electrolytes. Also she's likely to be very sore when defecating so plenty of linseed oil in her feed to soften her up.
I hope this helps,
 

Ad TB
Breeding Stock
Username: Ajvtbs

Post Number: 259
Registered: 01-2009
Posted on Monday, April 06, 2009 - 07:39 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

How's she doing today Susannah? I was wondering what meds has the vet got her on?
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 36
Registered: 10-2005
Posted on Tuesday, April 07, 2009 - 06:55 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

We took her to OSU last night. We just couldn't give her the care she needed at our place if she was going to pull through. So far so good and the vets there agree that it seems like nerve damage so far. My mare has been such a sweetie and is good in the sling. We're taking it day by day. I'll keep you updated.
 

Ad TB
Breeding Stock
Username: Ajvtbs

Post Number: 274
Registered: 01-2009
Posted on Tuesday, April 07, 2009 - 07:02 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

That's great Susannah. You'll probably see a quicker improvement with her in a sling and she'll be more comfortable. Keep us posted
 

Jan Owen
Senior Stallion or Mare
Username: 1frosty1

Post Number: 2333
Registered: 04-2006
Posted on Wednesday, April 08, 2009 - 12:22 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

That is progress..I will be praying for you!
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 37
Registered: 10-2005
Posted on Wednesday, April 08, 2009 - 11:38 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

More good news! I called this morning and spoke with the vet to get an update. They put her in a different type of sling yesterday. This one she can rest in and they can keep her up longer. The vet said that she even moved her bad leg around a little bit! They're doing bloodwork to check for muscle damage and kidney function. She's been lavaged a few times and the last one was clean so that is also good. My poor sweet girl. We're all praying.
 

Kathee McGuire
Breeding Stock
Username: Katheekj

Post Number: 796
Registered: 12-2005
Posted on Wednesday, April 08, 2009 - 11:42 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

We are praying for you, too. Great to hear some good news!
 

Ad TB
Breeding Stock
Username: Ajvtbs

Post Number: 306
Registered: 01-2009
Posted on Wednesday, April 08, 2009 - 03:29 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Good news Susannah, the earlier you see muscle function return the better. Praying for her too
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 38
Registered: 10-2005
Posted on Thursday, April 09, 2009 - 11:25 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

The bloodwork came back great! I also found out the new sling is an Anderson sling. She's moving around the stall some and the vet said they couldn't ask for anything more from her. She'll probably be at the clinic for another two weeks. I can't wait to go see her on Saturday!
 

Ad TB
Breeding Stock
Username: Ajvtbs

Post Number: 333
Registered: 01-2009
Posted on Thursday, April 09, 2009 - 11:57 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Great news Susannah, it's fantastic that she can move around in the sling. I'm so glad she's improving
 

Jan Owen
Senior Stallion or Mare
Username: 1frosty1

Post Number: 2343
Registered: 04-2006
Posted on Thursday, April 09, 2009 - 01:59 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Ssannah..that is excellent news! Thanks so much for sharing...and we will continue to support you!
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 39
Registered: 10-2005
Posted on Saturday, April 11, 2009 - 10:39 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Just got back from Columbus and I'm trying to stay positive. She's comfortable and relaxed in the Anderson sling. While we were there we did not see her actually walk around on the right hind leg but all over she seems stronger. When we had her at home and she had assistance to stand on her feet she would tremble all over for much of the time she stood. Today in the sling I only noticed a little quivering above her right hind-leg. She is now able to flex that leg up towards her belly. The vet feels that she is regaining a small but tangible amount of motor function in the leg and that she is more aware of it as opposed to a few days ago when it was more rubbery and she would let you do whatever to it.

All we can really do is wait. On Monday I'll find out what our bill is up to that point and will also get a better idea of what the costs will be per week moving forward.

I'm planning to visit her again next Saturday. It's a 4 hour trip one-way so I'm going to spend the night and visit her on Sunday instead of going up & back in one day. I'm soooo tired.
 

Kathee McGuire
Breeding Stock
Username: Katheekj

Post Number: 875
Registered: 12-2005
Posted on Saturday, April 11, 2009 - 11:05 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Sounds like you have a long trek ahead of you. Our prayers are with you and please keep us update on her progress.
 

Jennifer Seaman
Weanling
Username: C_j_quarterhorses

Post Number: 41
Registered: 01-2009
Posted on Saturday, April 11, 2009 - 11:57 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Susannah - OSU is a good hospital. I am only 40 mins away from there and if I can help just let me know...Jen
 

Ad TB
Breeding Stock
Username: Ajvtbs

Post Number: 403
Registered: 01-2009
Posted on Sunday, April 12, 2009 - 04:27 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Sussanah, any return in motor function is a good sign. Keep positive, neurological recovery is slow. It is a bit of a waiting game to see how much she recovers but she seems to be in the best hands. Wishing her further recovery
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 40
Registered: 10-2005
Posted on Sunday, April 12, 2009 - 05:21 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Thank you. I know the vets are encouraged but did stress to us that nerve damage heals very slowly. Yesterday was her fifth day at the clinic and up in the sling. I'm sure it took 2-3 days for her to be steadier on her feet after being down on her left side so much at our place.

Some other good things to see were that she can posture more normally to urinate and the swelling in her vulva has gone down ALOT.

With her in the sling we were able to get a good look at her left leg. She now has a pretty large patchy of thickened crusty/scabby skin below her flank running along the whole side of her leg from being down so much the first five days after foaling. They're hoping that it will heal from the inside out so we don't have to deal with such a large sore. The good thing is that she can stay up so long in that sling and won't cause further damage to the area.

I'm praying for positive signs of improvement this coming week. I'm so afraid of this being permanent damage.
 

Tim Popovitz
Breeding Stock
Username: Dystocia

Post Number: 155
Registered: 02-2008
Posted on Sunday, April 12, 2009 - 11:56 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Suzannah,
As you know, the odds improve a little bit every day. We had a similar case earlier this year only ours didn't fare so well, she fought the sling from the beginning. If your mare is being a good patient, there is every reason to be optimistic.
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 41
Registered: 10-2005
Posted on Monday, April 13, 2009 - 11:14 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Tim,

I'm so sorry to hear that. Was it nerve damage from a dystocia as well?
 

DTQH
Nursing Foal
Username: Dtqh

Post Number: 19
Registered: 02-2009
Posted on Monday, April 13, 2009 - 11:43 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Susannah,

My thoughts and prayers are with you. Stay positive, and remember to take care of yourself too!
 

Tim Popovitz
Breeding Stock
Username: Dystocia

Post Number: 156
Registered: 02-2008
Posted on Monday, April 13, 2009 - 10:58 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Yes Susannah, real similar. Foals hind leg lodged in the birth canal. We finally got her tranqued enough to get the hind leg pushed back and took the foal, he was dead of course. We then had the local horse ambulance ship the mare to the hospital, got her in the sling then she began to prolapse her uterus. So they had to get her out of the sling, during which, she fractured her femur. So we lost the foal AND the mare. To add to the tragedy, her foal last year fractured his cannon just before weaning and had to be euthanized.


Don't let me bring you down though, I deal with numbers in the hundreds, so this stuff seems to happen due to the odds. It sounds as though you are on a good path, even the silghtest bit of improvement is a blessing in these cases.
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 43
Registered: 10-2005
Posted on Tuesday, April 14, 2009 - 06:19 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Oh my. My heart goes out to you.
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 44
Registered: 10-2005
Posted on Tuesday, April 14, 2009 - 10:48 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Janie update:

No improvement since yesterday. The vet said she seems to be putting a little less weight on her right hind and in the past 24 hours she's had dramatic muscle loss (approx 50%) in that leg. It's not unexpected since she's not been walking on it for almost two weeks now. Is it bad that it happened suddenly rather than gradually?

Her respiratory rate was a little elevated. The vet is attributing that to the fact that she's been in the sling for a few days straight. They're going to let her out to resting laying down for a few hours today. While she's down they'll check her left hind hoof for any signs of abcessing or laminitis and will probably put some packing in the sole for support.

If she shows no signs of improvement by the end of the week they will most likely run a test called an EMG on her to find out the level of nerve activity in her muscles. Has anyone had this test run on their horse? The vet said it would help determine her long-term prognosis.

The vet says she may need 2-3 more weeks in the sling.

On a good note, Janie is still happy, eating and going to the bathroom.
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 45
Registered: 10-2005
Posted on Tuesday, April 14, 2009 - 11:11 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

AD TB - in your original post you mentioned electrical stimulation of the muscles could be beneficial. Can you tell me more?
 

Ad TB
Breeding Stock
Username: Ajvtbs

Post Number: 454
Registered: 01-2009
Posted on Tuesday, April 14, 2009 - 03:17 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Don't loose heart Susannah, nerve injuries are incredibly slow. Firstly about the muscle wasting, the reason it's been so rapid is that it's called neurogenic atrophy, it's not because she's not using the leg it's because the nerve is not innervating (sending signals) to the muscle so the muscle is not being activated. Neurogenic atrophy is always very rapid and you can often see signs after only a few days. The other type of muscle wasting is disuse atrophy which is as a result of not using the muscle, not walking etc, it's much more gradual and comes on over several weeks, typically six weeks or more. It's never as severe as neurogenic atrophy as the nerve is still working and therefore the muscle can still contract and the tone in the muscle is still the same.

The EMG test, Electromygraphy will probably be performed using needle EMG where a needle is inserted into the muscle and it will register the electrical activity within the muscle. It's a good indication of how much activity is going on in the muscle and therefore if the nerve is active at all or how much it is working. It will help to give a long term prognosis because it will determine the severity of nerve damage.

Electical muscle stimulation can be beneficial, the aim of it is to activate the muscle using a current, therefore the nerve does not need to be activated. There are also various tests that can be done that can show how much current is required to get a muscle contraction and therefore how severe the damage is. With horses carbon elecrodes with a transmission gel are placed on the muscle. A test is first carried out to determine where the action point of the muscle is ie: the point that responds or contracts most with electrical stimulation. A static (non movable) electode is placed here and another movable electode is moved around the entire muscle to get the rest of it to contract. Electrical muscle stimulation is of great benefit to prevent muscle wasting with nerve injuries, and is well worth a try. It's also easy to carry out and horses seem to actually like the sensation.

I hope this helps. Keep us posted on how she's doing.
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 46
Registered: 10-2005
Posted on Wednesday, April 15, 2009 - 01:29 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Janie update:

Yesterday they took some radiographs of her left hind hoof and confirmed that she has mild laminitis. She's actually 'sinking' into her hoof. They raised the sling a bit to give her more support, packed and wrapped her hoof and have her on morphine. Now that the pain is being managed she is still happy and eating.

The progress with her right hind leg has leveled off for the time being. I'm sure the laminitis in her other foot didn't help. Now we wait to see how what happens with the laminitis and if they can manage her pain.
 

Dorthy Brown
Breeding Stock
Username: Dodib

Post Number: 372
Registered: 04-2006
Posted on Wednesday, April 15, 2009 - 02:53 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Aw still praying for her
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 47
Registered: 10-2005
Posted on Monday, April 20, 2009 - 03:42 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

LOOKING FOR A FACILITY NEAR OHIO STATE UNIV.

A few weeks ago I posted a message about needing a sling for my mare. We ended up trailering her to OSU and she'll have been there two weeks tomorrow. She has something very rare - Obturator Paralysis - as a result of a dystocia and cannot stand on her own or walk. Janie has been an excellent patient. Tomorrow they will do an EMG test on her to find out the extent of the nerve damage. If the results are good then we will need to find a facility close to OSU that is willing to manage her in the sling and that the vet can visit weekly to monitor her. OSU will loan out a sling for her.

If you know of a place, please contact me. If her test results are good, she will just need time. I have to give her a chance. She's too nice of a mare to give up on.
 

Rusti - Chilli due 4-09
Breeding Stock
Username: Rusti

Post Number: 182
Registered: 12-2008
Posted on Tuesday, April 21, 2009 - 02:59 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

I'm sorry I can't help but I just wanted you to know that I will say a prayer for you and your mare and I'm wishing you all the best. Keep us updated.



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