pastern arthrodesis updated and question #174 [Archive]

Fharoah

Jun. 26, 2009, 08:47 PM

He was doing great had just one his flat class the day before he first went lame. My horse had a mild intermittent lameness that started March 26th, 2007. He was pronounced sound ten days later. He was on and off basically so mildly uneven that my trainer didn't even notice. June 07 he has acute swelling and increase in lameness my vet palpated a very sensitive splint and said six weeks. Six weeks later July 31st, 2007 he improved allot but not sound we could not block him out of the lameness, radiogarphs of his cannon bone were clean. My vet suggested a month of walking and a gram of bute. September 07 my vet said no improvement I was refereed to lameness specialist. As I could not haul him at that time he remained on rest with walking. He saw 2nd experienced equine vet in October 07 who thought it was a shoulder injury and I was referred to radiograph his shoulder. October 07 lameness specialist isolates the lameness 70% improvement to the sesmoid block, diagnoses pastern lameness he was a 2/5 and moderately positive to distal flexions. Pastern radiographs are clean so rest with walking is advised. He was a nightmare to walk all winter. As there was disagreement and my parents owned the horse equine vet returns November 07 and blocks the sesmoid and sees no improvement. March 08 horse still a 2/5 but only mildly positive to distal flexions. His shoulder was also radiographed and normal. Radiographs were clean 85% improvement was seen to the 4 point low. Steroid HA injection resulted in big improvement lasted about four weeks then he was worse. MRI revealed collateral ligament desmititis and small tear in deep digital flexor tendon and sesmoidean ligament desmitis. Second opinion suggestion mineralization in the collateral ligament and changes in the tendon and navicular bursitis who's right I will never know. His pastern and tendon sheath were injected with steroid HA. He was put in wide webbed shoes with rolled toes given monthly legend and weekly adequan and rested for six months. He improved to a 1/5 Enthesyophyte on his radiographs. He started a slow progressive hand walking program. February 2009 he was an intermittent 1/5 and radiographs were the same. We did IRAP and rehabbed as prescribed. He would take the occasional short step in trot and felt oddly gimpy at the walk but I was told to keep going. June 2009 he was an intermittent 1/5 diagnosed with ringbone lame at the walk (he is different), his elbow was also radiographed and normal. We gave him another IRAP injection but he continued to regress. He was turned out 24/7 and given a bottle of recovery EQ HA double dosed for June he regressed. July 09 he was given adeqaun which helped and was taken for some walks undersaddle but remained lame. August 2009 he. was a 2/5 and positive to distal flexions, and had pastern arthrodesis surgery. Recheck in November 2009 revealed both lag screws were broken. His radiographs also show the start of fusion and bone should grow over the screws which are stable. He remains on stall rest until recheck in February, we are optimistic as is my surgeon. The prognoses is good for ridding soundness!

JMurray

Jun. 26, 2009, 08:56 PM

Fharoah

Jun. 26, 2009, 09:49 PM

Fharoah,

I have not much to offer except my shoulder to cry on. I can hear your personal pain as I read your last post.

My only advice is to go with your gut as to what is best for your horse. Consider what is best for him. Trust yourself.

You will get a lot of support, opinions and personal experiences on this board but in the end you will need to decide the best course of action for your friend.

-J

Thankyou! I would like to do the surgery in hopes to give him a fair chance of soundness sergeon says 75%. I however would not want put him through if he were to suffer from navicular disese and be lame anyway. Surgeon says no navicular despite changes on films. He has intermittent very mild lameness and or shortening of stride. Because the lameness is so subtle on and off with good and bad days I am concerned that he actually could have the early onset of navicular does not show consistent lameness to block and the origional nerve blocks were low 4 point block (basically fetlock down includding the foot) 85% improvement so does not exclude the foot in my opinion. I am also concerned because if the second opinion on the MRI was correct then the tendon was calcified and the prognoses for the surgery would be not so good. If I trust my sergeon who I highly respect then the surgery is his best chance. However my sergeon never looked at the MRI, he didn't want to so how can he be so sure the tendon is mineralized. Also the second opinion fit better to be than the origional diagnoses but I really don't know. I could just trust my vet but I don't want to put him through a painful surgery with an uncertain prognoses.

JMurray

Jun. 26, 2009, 11:26 PM

So going over you latest post, I would recommend you have a heart to heart with your surgeon and have them honor your concerns with a frank discussion. There is no reason why they should not look at the MRI.

When I had a similar disagreement with a vet at New Bolton, I called up his secretary and made an appointment to meet him at New Bolton in his office to specifically talk about my concerns and get the issue resolved, which it was. I told him I needed him to listen to my concerns and talk to me about them so we could make the right decision for my horse.

Just a suggestion. I feel your struggle with this and I can see from your last post you need more information to make the right choice for your friend.

-J

mbv

Jun. 27, 2009, 10:09 AM

You could also consider having the MRI read by another radiologist (either at the same vet school, or another one). Radiologist consult fees are usually pretty reasonable (usually the most expensive part of the MRI is doing the anesthesia and using the $$ machine..you've already got that covered). Most images can be sent digitally so you should be able to get pretty good turnaround time.

Seems like your surgeon should want to take a look at the MRI?? If he's saying no navicular because of rads, but the radiologist is saying navicular due to the MRI, I would have to go with the MRI results. MRI is pretty much the gold standard for looking at navicular problems. To maintain peace perhaps he could recommend a boarded radiologist that he likes to work with for a 2nd opinion of the MRI so that he would be less dismissive of the interpretation?

BornToRide

Jun. 27, 2009, 10:43 AM

Totally what MBV says!! I get the feeling this surgeon has more ego than solid advise - that's never a good sign! Or perhaps he's simply looking for more income, rather than what's in the best interest of this horse!

Navicular horses tend to toe load. That tends to cause the soft tissue irritation around the navicular bone. From what I have seen I think that's what your horse does on the affected leg.
Here are excellent examples and more info on the subject: http://rockleyfarm.blogspot.com/2009/06/hoof-rehab-angel-hooves.html and more about the case from one of the owner of the farm here, post #24 http://www.chronicleforums.com/Forum/showthread.php?t=211222&page=2

If this was my horse, before doing any surgery, I would find myself a good barefoot trimmer, pull those shoes and allow the horse to heal out in pasture for several months or perhaps even a year, just to see what I'd get.

Pancakes

Jun. 27, 2009, 10:47 AM

This is my situation

My gelding was diagnosed a year ago by MRI as having collateral ligament desmititis in his pastern joint, and a small tear in the deep digital flexor tendon at the region of the fetlock.
He was treated with six months total rest, 7 months very slow rehabilitation program, IRAP, adequan, legend and recovery EQ HA, wide webbed shoes with rolled toes. Surgeon kept watching videos and told me to keep going.

It did not end well and he now has high articular ringbone and I am planning on arthrodeses surgery.

I origionally got a second opinion on the same MRI. She said it was enlarged and mineralized and the deep digital flexor tendon was mineralized, and pointed to some other issues e.g. navicular disese.

My sergeon dismised the second opinion which was from a very good professor at unniversity who only reads MRI's eventhough he did not look at the MRI himself. Now considering arthrodeses surgery the prognoses may be affected if the ligament is mineralized.

My sergeon says no clinical signs of navicular disese, despite mild remodeling and bursitis on his MRI. I am torn over how to proceed and who to trust.
It is so frustrating because I get an MRI and now I do not know who is right!

does anyone have a horse with a calcified tendon or ligament? Does anyone know if a horse can be sound on a calified tendon or ligament? Would a horse with a calcified tendon or ligament be sensitive to palpation?

Does anyone no about arthodeses surgery on a horse that has mineralization in there tendon?

I feel very lost just really wish I could help my beloved horse!

Getting a second opinion can't hurt if you really are concerned about things. Different vets have different experiences and preferences.

I'm sure there are horses out there that can be sound with a calcified tendon or ligament, but it depends on which tendon, which ligament, how much calcification, any other complicating factors, etc... same goes for whether you'd see pain on palpation. It's not a black and white kind of thing.

I can tell you that we just had a horse in the hospital with an arthrodesed pastern joint. He was completely sound! The only reason he came in was for extra bony grown around the arthrodesed joint which was removed/shaved down surgically for fear that it might start to rub on the tendon sheath (it wasn't yet). It was an impressive amount of bony growth, too, but the horse was completely sound!

Pancakes

Jun. 27, 2009, 11:04 AM

Totally what MBV says!! I get the feeling this surgeon has more ego than solid advise - that's never a good sign!

Navicular horses tend to toe load. That tends to cause the soft tissue irritation around the navicular bone. From what I have seen I think that's what your horse does on the affected leg.
Here are excellent examples and more info on the subject: http://rockleyfarm.blogspot.com/2009/06/hoof-rehab-angel-hooves.html and more about the case from one of the owner of the farm here, post #24 http://www.chronicleforums.com/Forum/showthread.php?t=211222&page=2

If this was my horse, before doing any surgery, I would find myself a good barefoot trimmer, pull those shoes and allow the horse to heal out in pasture for several months or perhaps even a year, just to see what I'd get.

If you threw a horse like that out in a pasture for a year with no shoes, I bet you'd see the ringbone would be worsened and the horse become increasingly lame. Not something I would do. This horse has too many issues (collateral ligaments, DDF tear and remodeling +/- navicular bursitis/navicular issues).

BornToRide

Jun. 27, 2009, 11:10 AM

If you threw a horse like that out in a pasture for a year with no shoes, I bet you'd see the ringbone would be worsened and the horse become increasingly lame. Not something I would do. This horse has too many issues (collateral ligaments, DDF tear and remodeling +/- navicular bursitis/navicular issues). How can you be so certain? We actually generally see an improvement if the horse is trimmed correctly (biomechanically correct) and allowed to heal. Ringbone can be reduced or even eliminated in some cases if given half the chance with correct support.

Remember the shoes and incorrect hoof form tend to create the problem to start with, not bare hooves! Shoes also increase the concussive forces joints sustain plus create more instability on smooth surfaces and toeque on soft ground - that's the last thing a horse with ringbone or other arthritic changes needs!

When researching his files, Dr.Teskey found that over 80% of the shod horses in his practice have some sort of limb soundness problem!

If you are interested to read more see here: BETTER OFF BAREFOOT (http://www.easycareinc.com/education/whybarefoot.aspx)

And this:

Also just a short five years ago, I was prescribing egg-bar shoes, pads and impression material for any number of lamenesses, but since seeing first hand the further damage caused by these appliances, I have discontinued such prescriptions. No matter who the farrier was, none of these horses ever reached a point of soundness where they could walk comfortably on their own feet, and now I deeply regret that many horses died at my hands because I didn't know what to do to preserve or save them. Now when I see horses with severe foot problems, I treat them without prescribing shoes, often without anything more complicated than proper trimming of their hooves, appropriate movement, and a natural diet. There have been a number of horses that I have brought to full soundness after I was called to euthanize them. Their owners were told by their farrier, friends and veterinarian that there was nothing that could be done for navicular disease or founder or quarter cracks. Most of these horses are better in a short time. The personal satisfaction I get when I help save a "hopeless" case or the relief in the eyes of owners when they realize they'll never have to shoe their horses again, and the gratitude and admiration I receive from these folks is heartwarming.
http://www.easycareinc.com/Education/articles/breaking_traditions.aspx

Pancakes

Jun. 27, 2009, 11:17 AM

How can you be so certain. We actually generally see an improvement if the horse is trimmed correctly (biomechanically correct) and allowed to heal. Ringbone can be reduced or even eliminated in some cases if givenm half the chnace with corect support.

Remember the shoes and incorrect hoof form tend to create the problem to start with, not bare hooves! Shoes also increase the concussive forces joints sustain plus create more instability on smooth surfaces and toeque on soft groudn - that's the last thing a horse with ringbone or other arthritic changes needs!

When researching his files, Dr.Teskey found that over 80% of the shod horses in his practice have some sort of limb soundness problem!

If you are interested to read more see here: BETTER OFF BAREFOOT (http://www.easycareinc.com/education/whybarefoot.aspx)

I refuse to get into this argument with you. Coming from a veterinary education with many, many top equine medical surgeons who have successfully treated thousands of cases, I have never heard any of them prescribe barefoot shoeing as a primary treatment option. Most likely the time it takes to "wait and see" if hoof shoeing/trimming change works is precious time where damage can occur and there should be other intervention that is proven to show benefit.

How many cases of ringbone + collateral ligament desmitis + navicular bursitis have you treated with barefoot trimming? Successfully? I'm not talking about just one of the problems, I'm talking about a horse with all 3.

80% of shod horses have limb soundness problems? What is the comparable % of barefoot-only horses with soundness problems? Or could it be that horses competing at higher levels with more stress put on their joints/limbs are shod, and therefore have a higher incidence of soundess problems? I'm not convinced.

I agree that barefoot trimming has its place, but for this horse, it would not be the place.

BornToRide

Jun. 27, 2009, 11:24 AM

Fharoah

Jun. 27, 2009, 11:25 AM

Thankyou I appreciate all the replys:

The surgeon says there are no clinical signs of navicular disese and MRI findings must be correlated by clinical findings. I am this horse did have clinical findings which were overlooked by the focus on his pastern, e.g. I think he was sensitive to hoof testers, pausitve to distal flexions, has a very subtle intermittent right fore limb lameness that comes and goes with good and bad days is not consistently apparent, I fear he is worse when his feet are due and the lameness is ecacerbated by any courcer footing, hills, declines and I feel like no clinical signs is him now being non responsive to hoof testers but I have it on good authority that does not rule out navicular disese. I respect sergeon lameness specialist and really hope he is right and no navicular and would like to do the surgery, just would hate to put him through such a sergery if there is any change he has active navicular disese. It was more the bursitis in the navicular bursa than the mild changes that scared me. When I got the second opinion from unniversity professor she discussed her findings with my sergeon and he dismissed then and stuck with the origional diagnoses. I am not saying who is right and who is wrong I understand MRI are not rocket science only that if the unniversity prognoses was correct in her reading the prognoses for the surgery may significently lower and I would not want to gamble with my most beloved horses welfare.

I do suspect that if I turn him out in a field for a year he will probablly become very lame as the ringbone progresses. He is less lame right now due to IRAP and adequan and recovery EQ HA but I think that only lessons his discomfort not eliminate it, he still shows minimal intermittent lameness, he is not sound but the lameness is not consistently apparent and virtually impossible to block, like he may trot out lame, trot out sound, then trot out short, he shows no lameness on the lounge but was an intermittent 1/5 on the ashfault on June 11th. I have thought about doing a bone scan, even the results of a bone scan must correlate clinical findings and he is not sensitive to any palpations or flexions even in his articular ringbone joint which has ugly xrays, he looks sore but is stoic and shows little lameness in trot.

BornToRide

Jun. 27, 2009, 11:36 AM

You bet this horse had clinical navicular signs, except they were attributed to something else! IMO any other possibly alternative should be first thoroughly be tried before resorting to surgery.

Carol Ames

Jun. 27, 2009, 11:43 AM

If there were navicular :sadsmile:what treatments :confused:would you have available?

Pancakes

Jun. 27, 2009, 11:56 AM

Thankyou I appreciate all the replys:

The surgeon says there are no clinical signs of navicular disese and MRI findings must be correlated by clinical findings. I fear this horse did have clinical findings which were overlooked by the focus on his pastern, e.g. I think he was sensitive to hoof testers, pausitve to distal flexions, has a very subtle intermittent right fore limb lameness that comes and goes with good and bad days is not consistently apparent, I fear he is worse when his feet are due and the lameness is ecacerbated by any courcer footing, hills, declines and I feel like no clinical signs is him now being non responsive to hoof testers but I have it on good authority that does not rule out navicular disese. I respect sergeon lameness specialist and really hope he is right and no navicular and would like to do the surgery, just would hate to put him through such a sergery if there is any change he has active navicular disese. It was more the bursitis in the navicular bursa than the mild changes that scared me. When I got the second opinion from unniversity professor she discussed her findings with my sergeon and he dismissed then and stuck with the origional diagnoses. I am not saying who is right and who is wrong I understand MRI are not rocket science only that if the unniversity prognoses was correct in her reading the prognoses for the surgery may significently lower and I would not want to gamble with my most beloved horses welfare.

I do suspect that if I turn him out in a field for a year he will probablly become very lame as the ringbone progresses. He is less lame right now due to IRAP and adequan and recovery EQ HA but I think that only lessons his discomfort not eliminate it, he still shows minimal intermittent lameness, he is not sound but the lameness is not consistently apparent and virtually impossible to block, like he may trot out lame, trot out sound, then trot out short, he shows no lameness on the lounge but was an intermittent 1/5 on the ashfault on June 11th. I have thought about doing a bone scan, even the results of a bone scan must correlate clinical findings and he is not sensitive to any palpations or flexions even in his articular ringbone joint which has ugly xrays, he looks sore but is stoic and shows little lameness in trot.

Get a second opinion on the MRI. Signs of navicular involvement (bursitis) can account for clinical signs. It may be worth doing a navicular bursoscopy to go in the bursa, clean it out if there is angry synovium in there, and treat it medically with polyglycan, perhaps IRAP. That's if someone agrees there's something there worth treating...

then again, without having seen the horse and doing the workup myself, I can't say for sure what he does and doesn't have. It very well could be the collateral ligament desmitis is causing the perceived foot lameness, or that there are subtle changes occuring at the navicular area that are not showing up on MRI. A bone scan might be worth doing only in the foot region if you really are worried about navicular involvement; you might see the navicular bone light up if there is active inflammation/bony changes occuring not yet able to be seen by the MRI. If you don't see anything, you can't say for certain there even are navicular problems, which is what your surgeon is saying.

Honestly, the surgeon's not wrong based on the information given and the experience he has. You're not wrong for wanting a thorough, complete answer with every avenue explored. If you are not convinced, you can have more procedures done (bone scan, bursa injections, shockwave therapy) to see if there really is navicular bursal involvement and problems. The question you need to ask yourself is if it's going to change what you do in terms of the desmitis and DDF tear. I suspect that arthrodesis and resolution of the pastern ringbone and lameness is going to better reduce the navicular problem (if present) than would treating the navicular problem. (sorry if that was confusing).

Sorry If I'm not articulating my words well. Arthrodesis is not a bad choice for the pastern joint; it is not as high-motion as other distal limb joints so horses do pretty well with it.

Pancakes

Jun. 27, 2009, 12:00 PM

Have you even read Dr. Teskey's experiences? Even he says that what he learned in vet school turned out not to be always correct. He's done to horses what they teach only to find that he had much better success with allowing the horse to heal while being barefooted!!

We (other barefoot trimmers and I ) see it all the time as well - more damage done to the soundness of the horse with shoes. One particular navicular gelding we know is now probably going to be put down after every possible showing solution has failed this horse!! I wish I had the facility and resources to take this horse and proof to the nay-sayers that it is indeed possible to improve a horse like this much better by allowing him to go bare.

The problem is that the damage has been done...no shoes are not going to resolve that problem or make the ringbone go away. The tendons and ligaments have been damaged. There is articular damage that is being kept at bay with IRAP and joint injections. That damage is not going to go away with barefoot trimming. I can't emphasize this enough. It is not a simple navicular problem! You haven't seemed to grasp this concept.

You still haven't answered the question about shoeing and coincidence of lameness as that statistic (the 80% one). And broad, sweeping generalizations like "more damage done to the soundness of horses with shoes" is absurd. Improper shoes can cause soundness problems. Proper shoeing does not. I can't say whether this horse did or did not have proper shoeing, and I agree if he did not before he should now, but shoes themselves are not the issue here. And allowing a horse to heal while barefoot may work in some instances, but not all. I don't think this is one instance. Are you qualified to make that assessment for this case?

Please spare your quotes for me. I am quite open to learning new things and new treatments but not when it could compromise patient care, comfort, and affect prognosis.

Your resentment for veterinarians and dismissal of the quality of their education is quite clear in all of your posts. I really wonder why you have such feelings. Hm.

Fharoah

Jun. 27, 2009, 12:07 PM

Get a second opinion on the MRI. Signs of navicular involvement (bursitis) can account for clinical signs. It may be worth doing a navicular bursoscopy to go in the bursa, clean it out if there is angry synovium in there, and treat it medically with polyglycan, perhaps IRAP. That's if someone agrees there's something there worth treating...

then again, without having seen the horse and doing the workup myself, I can't say for sure what he does and doesn't have. It very well could be the collateral ligament desmitis is causing the perceived foot lameness, or that there are subtle changes occuring at the navicular area that are not showing up on MRI. A bone scan might be worth doing only in the foot region if you really are worried about navicular involvement; you might see the navicular bone light up if there is active inflammation/bony changes occuring not yet able to be seen by the MRI. If you don't see anything, you can't say for certain there even are navicular problems, which is what your surgeon is saying.

Honestly, the surgeon's not wrong based on the information given and the experience he has. You're not wrong for wanting a thorough, complete answer with every avenue explored. If you are not convinced, you can have more procedures done (bone scan, bursa injections, shockwave therapy) to see if there really is navicular bursal involvement and problems. The question you need to ask yourself is if it's going to change what you do in terms of the desmitis and DDF tear. I suspect that arthrodesis and resolution of the pastern ringbone and lameness is going to better reduce the navicular problem (if present) than would treating the navicular problem. (sorry if that was confusing).

Sorry If I'm not articulating my words well. Arthrodesis is not a bad choice for the pastern joint; it is not as high-motion as other distal limb joints so horses do pretty well with it.

There are mild navicular changes on his xrays and MRI from a year ago, I don't know if that is significent at all. Washington State Unniversity also stated mild remodeling in the navicular bone with indication of inflammation around the seasomoidean straght on March 2008. CSU added mild Navicular changes changes and bursitis on his navicular bursa back in May 2008 MRI? Would that not be significent, my sergeon says no?

the collateral ligament desmitis of the pastern joint could that be ongoing for two years? His radiographs showed no arthritis in February 2009. Misdiagnoses after misdiagnoses it took a year to get the correct diagnoses. He had become virturally sound, enough that local vet considered him sound after a pastern injection of steroid HA back in March 2008 when he came up lame again four weeks later sergeon recommended the MRI.

We did rest and rehabillitation and he was an intermittent 1/5 then did IRAP and I was told to keep rehabbing as he was again almost sound, he remained almost sound for about three months. Then regressed and became very short stridded head bobbing lame at the walk, mild intermittent lameness at trot even sergeon had to say he shows lameness worse at the walk than the trot. We injected his pastern with IRAP and his walk inproved allot, he is still intermittenly lame at the trot, sometimes bobs his head, sometimes intermittently looks short, sometimes looks sound, he is different shows no lameness on the lounge in either dirrection. In his soundness exams since October 2008 he has been sound on the lounge and lame on the straight:confused:

BornToRide

Jun. 27, 2009, 12:08 PM

The problem is that the damage has been done...no shoes are not going to resolve that problem or make the ringbone go away. The tendons and ligaments have been damaged. There is articular damage that is being kept at bay with IRAP and joint injections. That damage is not going to go away with barefoot trimming. I can't emphasize this enough. It is not a simple navicular problem! You haven't seemed to grasp this concept.

Please spare your quotes for me. I am quite open to learning new things and new treatments but not when it could compromise patient care.

Your resentment for veterinarians and dismissal of the quality of their education is quite clear in all of your posts. I really wonder why you have such feelings. Hm.
I thought you did not want to argue with me about it?! :D Damage can be reversible or at least reduced. You are underestimating the healing power of the body :) If still in doubt, please have a look at the excellent work that is being done in the UK, as a research project with the University of Liverpool: http://www.rockleyfarm.co.uk/index.html

I do not resent veterinarians, or doctors for that matter....I resent their often closed mindedness when it comes to other treatment options! But to be fair, especially here in the US, they have too much to worry about possibly malpractice suits that makes them very reluctant to try something outside of what they have been trained to do.

Fharoah

Jun. 27, 2009, 12:48 PM

Get a second opinion on the MRI. Signs of navicular involvement (bursitis) can account for clinical signs. It may be worth doing a navicular bursoscopy to go in the bursa, clean it out if there is angry synovium in there, and treat it medically with polyglycan, perhaps IRAP. That's if someone agrees there's something there worth treating...

then again, without having seen the horse and doing the workup myself, I can't say for sure what he does and doesn't have. It very well could be the collateral ligament desmitis is causing the perceived foot lameness, or that there are subtle changes occuring at the navicular area that are not showing up on MRI. A bone scan might be worth doing only in the foot region if you really are worried about navicular involvement; you might see the navicular bone light up if there is active inflammation/bony changes occuring not yet able to be seen by the MRI. If you don't see anything, you can't say for certain there even are navicular problems, which is what your surgeon is saying.

Honestly, the surgeon's not wrong based on the information given and the experience he has. You're not wrong for wanting a thorough, complete answer with every avenue explored. If you are not convinced, you can have more procedures done (bone scan, bursa injections, shockwave therapy) to see if there really is navicular bursal involvement and problems. The question you need to ask yourself is if it's going to change what you do in terms of the desmitis and DDF tear. I suspect that arthrodesis and resolution of the pastern ringbone and lameness is going to better reduce the navicular problem (if present) than would treating the navicular problem. (sorry if that was confusing).

Sorry If I'm not articulating my words well. Arthrodesis is not a bad choice for the pastern joint; it is not as high-motion as other distal limb joints so horses do pretty well with it.

Thankyou! I really do want to do the surgery, my main concern was wether a calcified deep digital flexor tendon would make the prognoses for the surgery more dangerous?

Thereretically the tear in the deep digital flexor tendon and the collateral ligament desmitis should have healed with rest and rehabillitation and now we are dealing with ringbone. However the horse never came sound and always had good and bad days without another MRI I don't we can guarentee that, and I belive the collateral ligament desmitis of the pastern may may be route cause of the ringbone. I also wondered if the ligament was mineralized at 2.5 times its normal size if the joint remained instable and that was the route cause of the ringbone which layed down quickly when I started precribed rehab undersaddle in February 2009? My main concern is whether a mineralized collateral ligament and deep digital flexor tendon would affect the prognoses for the arthrodeses surgery?

He wares wide webbed shoes with rolled toes that have been mesured on xrays and are beautifully balanced. My sergeon really trusts and recommends my farrier, they work together sometimes. I plan to keep his shoes on, but will have to pull them for the surgery.

I am not sure another third opinion on the MRI which is a year old now? I think clinical signs have changed somewhat. I consider doing a bone scan or another MRI but it really adds up and the surgery is over 9k which I am happy with as the surgeon I really trust puts allot of care. I still would want to proceed with caution but would prefer to do the surgery sooner than later before the ringbone progesses anymore but also want to be cautious I am acting in the best interest of my horse.

Does anyone know any horses that had articulate ringbone that came sound on arthrodesed pastern joints?

LarkspurCO

Jun. 27, 2009, 01:03 PM

I thought you did not want to argue with me about it?! :D Damage can be reversible or at least reduced. You are underestimating the healing power of the body :)

BTR, you are overestimating by light years your qualifications to even venture to speculate on this horse. This is so far out of your league you couldn't touch it with a high-powered telescope. Enough already. Stop distracting the OP with this BS. She has a serious veterinary issue and the barefoot dogma that you "learned" from reading the Internet and watching some videos is not appropriate.

I do not resent veterinarians, or doctors for that matter....I resent their often closed mindedness when it comes to other treatment options!

And many of us here resent the arrogance with which you dismiss the fine work that they do (especially after you published your own hoof massacres).

But to be fair, especially here in the US, they have too much to worry about possibly malpractice suits that makes them very reluctant to try something outside of what they have been trained to do.

The usual bulltinky.

Pancakes

Jun. 27, 2009, 01:24 PM

Thankyou! I really do want to do the surgery, my main concern was wether a calcified deep digital flexor tendon would make the prognoses for the surgery more dangerous?

Thereretically the tear in the deep digital flexor tendon and the collateral ligament desmitis should have healed with rest and rehabillitation and now we are dealing with ringbone. However the horse never came sound and always had good and bad days without another MRI I don't we can guarentee that, and I belive the collateral ligament desmitis of the pastern may may be route cause of the ringbone. I also wondered if the ligament was mineralized at 2.5 times its normal size if the joint remained instable and that was the route cause of the ringbone which layed down quickly when I started precribed rehab undersaddle in February 2009? My main concern is whether a mineralized collateral ligament and deep digital flexor tendon would affect the prognoses for the arthrodeses surgery?

He wares wide webbed shoes with rolled toes that have been mesured on xrays and are beautifully balanced. My sergeon really trusts and recommends my farrier, they work together sometimes. I plan to keep his shoes on, but will have to pull them for the surgery.

I am not sure another third opinion on the MRI which is a year old now? I think clinical signs have changed somewhat. I consider doing a bone scan or another MRI but it really adds up and the surgery is over 9k which I am happy with as the surgeon I really trust puts allot of care. I still would want to proceed with caution but would prefer to do the surgery sooner than later before the ringbone progesses anymore but also want to be cautious I am acting in the best interest of my horse.

Does anyone know any horses that had articulate ringbone that came sound on arthrodesed pastern joints?

I understand your financial concern as well as the fact that you want to do something sooner rather than later (a good idea). I am looking for an answer for you as to whether the mineralization in the tendon and ligaments would make for a worse prognosis, but I am unable to find anything right now to that specific question. Theoretically, the pastern arthrodesis should stabilize the joint indefinitely to the point where any stress or strain put on those ligaments or tendons would be relieved, so there would be no further remodeling of them. I also would believe that the surgeon would not recommend the surgery if he felt the tendon/ligament issue would compromise the outcome.

If you have access to a literature search, you'll find that the success rate is pretty good (80-85% for soundness and return to exercise). I don't know how much, if any, lower that would be for your guy given the concurrent tendon/ligament mineralization. That would be a question for your surgeon!

Fharoah

Jun. 27, 2009, 01:33 PM

I understand your financial concern as well as the fact that you want to do something sooner rather than later (a good idea). I am looking for an answer for you as to whether the mineralization in the tendon and ligaments would make for a worse prognosis, but I am unable to find anything right now to that specific question. Theoretically, the pastern arthrodesis should stabilize the joint indefinitely to the point where any stress or strain put on those ligaments or tendons would be relieved, so there would be no further remodeling of them. I also would believe that the surgeon would not recommend the surgery if he felt the tendon/ligament issue would compromise the outcome.

If you have access to a literature search, you'll find that the success rate is pretty good (80-85% for soundness and return to exercise). I don't know how much, if any, lower that would be for your guy given the concurrent tendon/ligament mineralization. That would be a question for your surgeon!

Thankyou for the pausitive support! In your opinion would it be cruel to put a horse through pastern fusion surgery who could possibly have undiagnosed navicular onset, would that increase the chance of laminitis post surgery? I am certainly willing to do the most innovative treatments if that becomes a future occurance.

Pancakes

Jun. 27, 2009, 01:36 PM

I thought you did not want to argue with me about it?! :D Damage can be reversible or at least reduced. You are underestimating the healing power of the body :) If still in doubt, please have a look at the excellent work that is being done in the UK, as a research project with the University of Liverpool: http://www.rockleyfarm.co.uk/index.html

I'm not going to argue about shoeing; that is totally not the issue here. I will argue about you spouting off bad information when you really are not qualified.

I do not underestimate the healing power of the body; it quite amazing and that's exactly what we are FIGHTING here. The body had an insult; the pastern joint had an insult and reacts by healing...bony inflammation, proliferation, and trying to react to the insult. Unfortunately, that is causing pain to the horse and thus is a problem. Follow?

If you can prove that arthritis is reversible, do it! A nobel prize is waiting for you.

You really don't even understand the pathophysiology of the disease process. Once that damage is done to the cartilage, and the cascade started (metalloproteinases, IL-1), it is irreversible in the changes that have been made. Care for me to go on? This is what a veterinary education gets you, or even someone who cares to be informed enough to look it up in a book. Going on websites about barefoot trimming and helping tendinitis is totally irrelevant as we are talking about RINGBONE and periosteal reactions/arthritis here. Bone does NOT equal tendon.
Here, a simple google search of "equine degenerative joint disease" brings you this: http://veterinarynews.dvm360.com/dvm/Veterinary+Equine/Effectively-diagnosing-treating-equine-degenerativ/ArticleStandard/Article/detail/75368

Think that is still reversible, or even treatable, with trimming?

If you would like to treat your horse and your clients with trimming for all their lameness and orthopedic diseases, be my guest. Fortunately most of the COTH members know better than to listen to you, but it really is annoying and downright harmful when you suggest treatments for diseases you don't understand when you are not qualified to do so.

And as for vets' close-mindedness about other treatment options, I challenge you to pick up Adams' Lameness of the Horse and look at the chapters of non-traditional therapies. That book, the "bible" of equine lameness, clearly shows that vets are not close-minded. Numerous CEs and conferences are held every year to that extend. However, they, unlike you, know when and where these treatments should be employed, based on the pathophysiology of the diease process.

Fharoah

Jun. 27, 2009, 01:38 PM

My horses injury is right front pastern joint, controversal wether there are any right front navicular issues. There are changes pressent on films but those could be inconsequencial, right?

Pancakes

Jun. 27, 2009, 01:41 PM

Thankyou for the pausitive support! In your opinion would it be cruel to put a horse through pastern fusion surgery who could possibly have undiagnosed navicular onset, would that increase the chance of laminitis post surgery? I am certainly willing to do the most innovative treatments if that becomes a future occurance.

If the navicular onset coincides and is within the same timeline as the pastern ringbone, I think they may be somewhat related, and by resolving the pastern problem you may be alleviating the strain on the DDF and thus alleviate the navicular problem, if there is some. I think it's worth the try.

I don't know if the chances of laminitis post-surgery would increase; usually they are on the other leg due to increased weight put on it post-surgically. I tend to think this complication can happen with or without the navicular issue, but I can't say for sure (and can't find a study to prove one way or the other) whether navicular would make laminitis more likely.

It might be a wait and see game; wait and see if he gets through the arthrodesis okay and if that resolves the lameness. The time spent in stall rest may help the navicular, if any, as well. If you monitor closely for laminitis, you could help prevent that if it does try to occur. These are all great questions for your surgeon who probably has read much more of the literature and has much more experience than I do. I think all of your concerns are very valid and you should express them, but I have a feeling they will not be enough to counteract the benefits of the arthrodesis surgery. I hope this helps!

Janet

Jun. 27, 2009, 01:49 PM

Fharoah

Jun. 28, 2009, 01:31 AM

It sounds as if you have one vet who has looked at the horse clinically, but as not looked at teh MRI, and a second vet who has looked at the MRI but has not examined the horse clinically.

I probably wouldn't procede until I had at least one (and preferably two) vets who have BOTH examined the horse clinically AND looked at the MRI.

Ya I would love another opinion. I am really worried about my horse. It is hard for me because I donnot have unlimited funds. I feel that the onset of ringbone and the onset of navicular. His exrays look painful as the joint has narrowed and there is remodeling and spurs and ouch yet he is negative to forced flexions and sergeon flexes hard and shows such minimal intermittent lameness I can't block him:(

BornToRide

Jun. 28, 2009, 10:55 AM

Bone is a very dynamic substance - it is naturally remodeled all the time, which means that there's definitely a possibility that any chnages could be at least reduced, if not re-absorbed, as long as the correct biomechanics are re-established!:)

deltawave

Jun. 28, 2009, 11:26 AM

There is also a chance that it will snow today in Miami, Florida. :)

BornToRide

Jun. 28, 2009, 11:30 AM

Yeah, those are usually those miraculous recovery cases that doctors just cannot explain according to their world. :cool:

deltawave

Jun. 28, 2009, 12:12 PM

Miracles don't belong in the "world" of science, and by definition cannot BE explained. They belong in the house of worship of one's choice.

However, if you've got one to show us, it IS Sunday. Let's see. :yes:

LarkspurCO

Jun. 28, 2009, 12:17 PM

Yeah, those are usually those miraculous recovery cases that doctors just cannot explain according to their world. :cool:

Miraculous? So now all that is required to heal the horse is divine intervention? It's too bad all of the narrow-minded researchers are wasting their time searching for new and better treatment options.:rolleyes:

http://www.equineortho.colostate.edu/current.htm

(Off to call sister in Florida to warn of impending snowstorm.;))

Fharoah

Jun. 28, 2009, 01:34 PM

I think the best thing would be if I could talk my sergeon into reading the MRI. He is very qualified and as long as he gives me his unbiased opinion that there are no perminent changes which will be depremental to a secessful outcome on the surgery I will feel so much more confident. I have to wait until Augest to do the surgery because we injected with IRAP on June 11th.

BornToRide

Jun. 28, 2009, 05:08 PM

I do not know this surgeon you are talking about, but if he stands to gain any money from treating your horse and he's pushing for surgery, I'd be wary from what I have read so far here about him. I would possibly consult someone independent, before doing anything else.

Fharoah

Jun. 28, 2009, 06:21 PM

Surgery was not my first choice when he had clean xrays, we did two years rest and rehabillitation. I did everything my vets recommended. We did nerve blocks xrays, flexions, MRI, more xrays, more soundness exams, was and am still possibly willing to do a bone scan. I was willing to do stem stell, shockwave, IRAP, steroid HA injections, adequan, legend, tildren, barefoot if it had been recommended by my very knowledgeable vets which it wassn't, four different vets includding a big vetrinary hospital, he has had two years to heal himself, we did a rehabillitation program but that was primarily walk and he had some really promissing days with only a few short steps. He had a full 1.5 years nothing more than rest and walking and yes turnout with all him supplements. His shoulders have been xrayed his elbow has been xrayed simply because trainners and people accosiated with the horse. Now I can see the narrowing on the xrays, the remodeling, the spurring, is osteoarthritis bone on bone? Ouch that is not going to reverse itself. I have consulted with other unniversity professors who say the surgery works very well, I am just trying to sort out if he has any other issues that would have an adverse effect on a secessful surgery. Changes on films can inconsequensal unless and must be supported by clinical signs. My horse has no sensitivety to hoof testers what so ever (pressed hard) he has always had clinical signs in his pastern. That does not rule out navicular but ringbone and navicular can pressent in simular matter. Which is why I am proceeding with caution, however would like to do this in a cost without spending more than I have too.

Fharoah

Jun. 28, 2009, 06:30 PM

PS I am not being pressured into this I would like this horse to live a painfree life if at all possible. Articular ringbone can be very delitating as it regresses and hard to manage although there are secess stories. My horse deserves a better quality of life!

Pancakes

Jun. 28, 2009, 06:45 PM

BTR, really, just stop. This is way beyond your comprehension. Saying bone will resorb and heal back into its own original state with time and no other treatment? Ridiculous. Talk to millions of people with arthritis and ask them. Arthritis will never go away on its own without things like Tildren, IRAP, or similar treatments. You clearly don't understand the physiology of bone remodeling and dynamics, and insinuating the vet is trying to make a buck off of this is insulting to vets and their level of knowledge. Go read a physiology textbook, or take a course (internet courses do NOT count). Get some real education. "Open your mind"

Fharaoh, it sounds like you have done enough up to this point where surgery is your best option. I asked my surgical resident today about your case and he said the ligament/tendon calcification should not be an issue since the arthrodesis stablizes the joint. As I mentioned before, we just literally had a horse with an arthrodesed pastern in who was completely sound and painfree. I would trust your surgeon's expertise that it's the ringbone that is present and needs to be treated. Good luck, I hope you are able to talk to him and all your concerns alleviated.

Mara

Jun. 28, 2009, 07:05 PM

BornToRide

Jun. 28, 2009, 07:16 PM

I also wish you the best. I really hope this will be final solution to his problem.

Lieslot

Jun. 28, 2009, 07:36 PM

I have nothing useful to add, really, except that I am jingling for a happy outcome whatever course you take.
And I think you, Fharoah, deserve enormous kudos and big hugs for your dedication to your horse, even though he may be only pasture sound when all is said and done. You are a credit to horse owners everywhere.

Well said. I think we all need to be out jingling like mad for both owner & horse. I've been in touch with OP for a while and she's a goldstar through it all for her horse. I really hope things will go right for both so they can enjoy some rideable future together.

Fharoah

Jun. 28, 2009, 08:04 PM

Thankyou all for the support! You have made me feel allot better about doing the surgery! I do hope to get a difinative awncer, before doing the surgery.

I really appreciate all the pausitive support!

beaulilly

Jun. 29, 2009, 02:46 PM

I had my mare's fetlock fused and they did a wedge osteotomy to straighten the leg as well. She ended up with a plate that went form her pastern to her knee with fourteen screws.

I started to write out my story for you then it turned into three pages on Word. So, I'll send it to you via PM!

Dazednconfused

Jun. 29, 2009, 03:26 PM

How can you be so certain? We actually generally see an improvement if the horse is trimmed correctly (biomechanically correct) and allowed to heal. Ringbone can be reduced or even eliminated in some cases if given half the chance with correct support.

Oh I dunno those years of solidly proven science, studies, experience, and oh yeah - SCHOOL - means she doesn't have a clue.

I wish someone would come along and hit you with a clue stick BTR.:eek:

Altitude Rider

Jun. 29, 2009, 03:36 PM

My 10 y/o TB Gelding was diagnosed with high ringbone in Feb. We did two Tildren treatments, HA/Coritsone injections, Equioxx, etc and finally went to the chemical fusion of the pastern. That was 8 weeks ago and he continues to deteriorate.

We tried a half shoe, an egg bar shoe, wedges, no shoes, etc and he continues to stay lame and the bone remodeling continues to worsen as evidenced by just looking at the pastern and x-rays. there isn't much hope that he will even remain pasture sound for long.

He continues to be fairly happy (though head bobbing lame) and likes to graze and play with his buddies. Until he tells me differently then I will continue to do my best to keep him happy. Since summer he has been stocking up periodically above the pastern.

He is such a sweet guy and was my competition horse though I have always babied him and given him a "bubble wrap" life.

It's happened VERY fast (the whole ringbone thing)...and when it came to our "last" options, my vet preferred the chemical fusing over surgery since the risks were much lower and the outcome is the about the same (for the most part). It was very quick and easy but unfortunatly did not change how lame he is.

very sorry this is happening to you...PM if you need more info. Ringbone sucks! :cry:

Fharoah

Jun. 29, 2009, 04:05 PM

Altitude Rider

Jun. 29, 2009, 05:39 PM

How advanced was the arthritis when you did the chemical fusion?
The arthritis was very advanced, "severe ringbone" as my vet put it, when we first took the x-rays and more so before we did the fusion.

Do his xrays show fusion?
I have not had an x-ray done since the fusion, he is going back for those soon, but the area has continued to thicken and is very notcible just from looking at it.

Was he on stall rest throughout the fusion
Nope, only for a day, another reason the chemical fusion is less impacting. This horse cannot tolerate stall rest for more than a day. We put him in a stall with a small "run-in" area outside of it when he was first diagnosed, while we were doing the Tildren injections.

Rick Burten

Jun. 29, 2009, 05:56 PM

I would possibly consult someone independent, before doing anything else.
Even if they too require a fee for services provided? ROTFLMFAO!

Rick Burten

Jun. 29, 2009, 06:02 PM

So now all that is required to heal the horse is divine intervention?
Andy or Bette Midler?:winkgrin:

Fharoah

Jun. 30, 2009, 02:18 PM

The surgery will be in Augest. I hope to sort out afew concerns but I have already decided on the surgery regardless of if he has any other issue.

Carol Ames

Jun. 30, 2009, 03:19 PM

I have never dealt with this, so have some basic questions; not in cases of rringbone but, an ankle which, had no ringbone, but had had chips, removearthroscopically, there was significant spurring , so, I retired her from competition; would fusion have been a viable option? the vet at the time, I was in Indiana, really did not have much experience with sport horses, except quarter horses barrel racing.:winkgrin:

Fharoah

Jun. 30, 2009, 04:09 PM

I have never dealt with this, so have some basic questions; in cases of rringbone but, an ankle which, had no ringabone, but had had chips, removed spectroscopically, there was significant spurring , so, I retired her from competition[; would fusion have ben a viable option? the vet at the time, I was in Indiana, really did not have much experience with sport horses, except quarter horses barrel racing.:winkgrin:

Does your horse have bone spurs in his pastern or fetlock
Is he lame right now?
How old is he?
Do you have current xrays

non articular ringbone where the bone spurs are not near the joint can be quite manageable
articular ringbone secondary joint disese of the pastern caries a poor prognoses for continued soundness, fusing is usually there best chance.
If your horse had non articular ringbone it is quite possible he will develope articular ringbone over time. Fusing is a good option if you can afford it. I personally would not feel comfortable with chemical fusing, but that is just me. It is possible to fuse a fetlock but a big procedure

touchstone-

Jun. 30, 2009, 06:45 PM

Arthritis will never go away on its own without things like Tildren, IRAP, or similar treatments. You clearly don't understand the physiology of bone remodeling and dynamics, and insinuating the vet is trying to make a buck off of this is insulting to vets and their level of knowledge.

Not to hijack too much, because I've been reading this story with interest and sympathy. Fharoah--I hope your horse gets the relief you've been trying so hard to provide!

But, since it came up, I was hoping that someone could explain how Tildren works as a treatment for arthritis. My dumb lay understanding of this drug is that it worked in the bones--not that it had any impact on joints. But this is the second recent mention I've heard about Tildren as a possible arthritis treatment (the other was my vet, in passing). I'd be grateful for any wisdom on this front.

Pancakes

Jun. 30, 2009, 07:13 PM

Not to hijack too much, because I've been reading this story with interest and sympathy. Fharoah--I hope your horse gets the relief you've been trying so hard to provide!

But, since it came up, I was hoping that someone could explain how Tildren works as a treatment for arthritis. My dumb lay understanding of this drug is that it worked in the bones--not that it had any impact on joints. But this is the second recent mention I've heard about Tildren as a possible arthritis treatment (the other was my vet, in passing). I'd be grateful for any wisdom on this front.

Tildren is a bone resorption inhibitor that acts by inhibiting osteoclasts. Osteoclasts are the cells that reabsorb bony matrix; osteoblasts are the cells that lay bone down. I should have been more specific in saying that Tildren is used mostly in cases of bone spavin (hocks) or navicular disease where bony remodeling is in the form of bone resorption. This is in contrast to "normal" arthritis where bony remodeling is in the form of bony proliferation, or extra bone (your typical articular "ringbone").

http://www.nwequinevet.com/?q=tildren

This site explains it pretty well if what I have said isn't clear enough (entirely possible after being on an overnight shift at the large animal hospital).

Carol Ames

Jul. 1, 2009, 12:17 PM

I was told many years ago, the:winkgrin: 60ies,, of a horse "at the team:lol:"who had fused ankles, and so, could not land on a slope, and so, cart wheeled:eek: over/ after ski jumps/ coffins; could this be so, is it true for fused joints?:confused:

Fharoah

Jul. 2, 2009, 12:32 AM

Pancakes

Jul. 2, 2009, 09:22 PM

Is it reasonable to request a maitnence dose of gastroguard during post surgery, he is sposed to stay with the sergeon for at least three weeks. My horse does not have ulcers to my knowledge, he is a bit sensitive to bute and will go off his feed after a while. He is the horse of a liffetime for me my best friend in the world and I really want him helped in every way possible!

Absolutely. Many horses that come in to our hospital are put on gastrogard or ulcergard or at least some sort of gastroprotectant for the duration of the stay. Most often these are orthopedic surgeries (like your guy), nervous horses, or TBs in general. Just ask the surgeon!

Fharoah

Jul. 2, 2009, 10:09 PM

when they arthrodeses on a pastern joint they don't have to break anything? Are they creating bone on bone. Are the horses typically given help with the discomfort post surgery?

Pancakes

Jul. 2, 2009, 10:53 PM

when they arthrodeses on a pastern joint they don't have to break anything? Are they creating bone on bone. Are the horses typically given help with the discomfort post surgery?

No, they don't have to break anything. They put a plate spanning the joint on one side and put screws in the bone to lock it in place in strategic places so it's the most stable and opposes bending forces of the joint. Horses are given as much help, both with shoeing and pain relievers, as possible post-surgery to eliminate discomfort. Rarely, in the cases of extreme chronic discomfort, a neurectomy is performed.

Fharoah

Jul. 3, 2009, 04:12 PM

Pancakes

Jul. 3, 2009, 06:07 PM

Does a neurectomy make the horse more sore once the nerve grows back?

How do they monitor for signs of laminitis, can laminitis be reversed if caught right away?

Do you see horses colic from the stress of surgery?

What is the occurance of infection, can it be beaten if treated agressively?

Have you ever seen a horse that couldn't fuse?

I can't say I have a lot of experience in this sort of thing, so these questions are best directed at your surgeon. He should be happy to answer these questions, as they are all valid and if your surgeon is performing the procedure, they are relevant to him.

touchstone-

Jul. 6, 2009, 04:33 PM

Tildren is a bone resorption inhibitor that acts by inhibiting osteoclasts. Osteoclasts are the cells that reabsorb bony matrix; osteoblasts are the cells that lay bone down. I should have been more specific in saying that Tildren is used mostly in cases of bone spavin (hocks) or navicular disease where bony remodeling is in the form of bone resorption. This is in contrast to "normal" arthritis where bony remodeling is in the form of bony proliferation, or extra bone (your typical articular "ringbone").

http://www.nwequinevet.com/?q=tildren

This site explains it pretty well if what I have said isn't clear enough (entirely possible after being on an overnight shift at the large animal hospital).

Thank you. Interesting.

Fharoah

Jul. 12, 2009, 06:48 PM

Serrgeon is looking at MRI, hopefully on Monday, fingers crossed!

Fharoah

Jul. 16, 2009, 03:32 PM

Surgeon said he was going to look at the MRI last Monday and then we could plan for the surgery so I am so patiently (not) waiting. It is ok, no pressure what so ever on the surgeon, I am just so curious but I am not going to bug him, just wait.

Diamondindykin

Jul. 16, 2009, 04:04 PM

OP ~ I did not read all the posts but I have a wonderful 18 year old reining gelding with high ringbone. He has always been sound but you can tell that the ringbone bothers him when doing spins to the left and sliding stops. Since he is such a great horse I considered having surgery to help him be more comfortable and to allow me to continue to show him. His x-rays were sent to Pilchuck Vet Hospital and they felt that he would have a 90% chance for a full recovery after surgery. The cost was estimated to be $5000 and the recovery time 9 months to a year. I struggled and struggled with the decision and had many conversations with the surgeon and my vet. What made me decide against the surgery was the recovery time and the amount of pain that the surgeon said that my horse would experience. According to him this is an extremely painful surgery and recovery. For me I realized that I was being selfish and wanted him better so I could show not necessarily for his benefit as the surgery would cause him much more pain than he was experiencing. I am not saying this is the case here at all but just the reasoning for me to decide not to do it!!

Good luck!

Fharoah

Aug. 1, 2009, 06:32 PM

I have booked the surgery he goes in on Tuesday and vet may examine him if lame enough we may do a palmar digital nerve block but I don't think lameness is consistent enough to block.

surgeon said collateral ligament desmititis. The considered the navicular bursitis to be insignificant.

Mara

Aug. 1, 2009, 08:07 PM

Jingling starts now!

Fharoah

Aug. 1, 2009, 09:36 PM

so surgery for wednesday which is great. He was sortof lame this summer and I did nothing more than a walk. so I booked the surgery and now he appears sound at walk and trot out of the blue like final adequan shot. No plan to cancel but my sergeon may think I am nuts and I feel stupid. What to do?

And I dought he would hold up to anything and even if the surgeon decided to hold off on the surgery which I will not cancel (just before) if would only be delaying the arthrodesis as unless there was something terribly else wrong with him I plan to fuse sooner or later, still I feel kindof pathetic right now.

Mara

Aug. 1, 2009, 11:23 PM

It's a big decision, and moments of uncertainty are perfectly normal; it's not one of those situations where it's obvious there's only one path to follow. So some second-guessing on your part is bound to happen, ESPECIALLY when he's having good days. Your surgeon has probably seen the same emotions from other owners in similar situations many times over. I'm sure he doesn't think you're "nuts" or "stupid".
FWIW, based on the history you've posted in this thread, I think you're making the right decision. :yes:

Fharoah

Aug. 2, 2009, 02:10 AM

I meant that he has been alittle lame all summer and on 24/7 turnout just hanging out. I booked the surgery now the horse is sound as in yesterday and Today. I spoke with surgeon yesterday Morning yesterday afternoon he troted around 100% sound. So I've booked to bring my now sound horse for surgery, a bit soon to cancel and there is no dought I am going to want the surgery sooner or later.

Altitude Rider

Aug. 2, 2009, 12:22 PM

Can anyone explain the pros/cons/circumstances for chemical fusion vs surgical fusion of the pastern joint (high)? Apparently using some type of alcohol injected into the joint is a fairly quick and painless process with much easier recovery time.

Does it have to do with degree of lameness, calcifications and/or joint damage? Also I would guess the history of the horse and how he might tolerate surgery and recovery could come into play.

Thanks

Fharoah

Aug. 5, 2009, 01:17 PM

Fharoah had a full soundness exam yesterday. He was worse, positive to flexions, lame on the lounge. I told my borded surgeon/lameness specialist to do whatever he thinks is best for Fharoah, he is getting surgery today. He had no sensitivty to hoof testers.

attitude rider I am sorry I know nothing about chemical fusion, it was never discussed.

Peggy

Aug. 5, 2009, 01:27 PM

I am sorry to hear that he was worse. Sending positive thoughts and jingles today for the surgery. Please update when he's out.

Fharoah

Aug. 5, 2009, 01:38 PM

he kept appearing better and worse good and bad days virtually sound, head bobbing I didn't know what was real.

Pancakes

Aug. 5, 2009, 07:00 PM

Hoping the surgery went okay and your guy is on his road to recovery!

Fharoah

Aug. 5, 2009, 07:29 PM

Hoping the surgery went okay and your guy is on his road to recovery!

Still waiting to hear from the surgeon. I talked to him about eight hours ago I am expecting a call from him in the near future.

Pancakes have you seen this surgery done? Can you see the navicular structures. My sergeon said there was navicular bursitis on the MRI but he didn't appreciate the significence of it. I was wondering if you would get a clear pitcure while doing the surgery. Does the suspensory ligament extend through the pastern or stop at the fetlock, sorry I am hopeless?

Peggy

Aug. 5, 2009, 08:10 PM

Suspensory ligaments keep going and wrap around to the front where they attach to the extensor process of the coffin bone (P3).

These diagrams may help:
Simple one: http://www.equine-research-inc.com/x-con_anat.htm
More detail: http://www.thehorse.com/ViewArticle.aspx?ID=7441

Really cool cutaway but can't find suspensory ligament on it:
http://www.horseshoes.com/anatomy/horsesense/horsesense.htm

Fharoah

Aug. 5, 2009, 08:21 PM

Thanks still waiting it is 5:15pm here.

Pancakes

Aug. 5, 2009, 09:12 PM

Haven't seen the actual surgery done, but you won't be able to see the navicular structures from the approach. See if the bursitis improves/worsens after the surgery...that's my feeling on it. Still sending good thoughts!

Fharoah

Aug. 5, 2009, 09:23 PM

Surgery went well, Fharoah is standing on the leg and waiting for dinner!

Peggy

Aug. 5, 2009, 11:47 PM

Thanks for the update and glad that it went well.

Fharoah

Aug. 6, 2009, 01:03 PM

For anyone who is interested he has got one plate incorperated screws. He will have a cast on for approximately three weeks in which he will stay in hospitalization. If that goes well the cast comes off and he comes home and will stand in a stall for three months hopefully I won't need sedation this time as ace and reserpine are basically have no effect on him so I would be at a loss over what to use. Then I imagine we will re xray and I will meticulously follow my vets instructions.

He has a bab habbit of banging the wall demanding food, always with his lame leg anyone have any ideas on how to curb this habbit? I am hoping won't be a problem since the surgery but he may still do it.

Quinn

Aug. 6, 2009, 01:20 PM

If he is banging his door, I'd put up a stall guard and let him hang his head out. Also, there's nothing for him to bang on then either. If it's the stall wall he's banging on, if you take old tires and cut them in 1/3 and bolt them to the wall (?) Sounds labour intensive but you have already done so much for this horse, what's a little more work?

Really pleased to hear the surgery went so well.

http://community.webshots.com/user/ballyduff

Fharoah

Aug. 6, 2009, 02:49 PM

His habbit for the past two years has been banging on his door. He always hangs his head out his stall guard proceeds to claw the sides of the walls, it is the oddest thing like my leg hurts lets bang it into the side of the doors? He is so smart and yet, I am hoping this won't happen this time around, it is a very odd habbit. He is just personality plus, adorable, wonderful with the dumbest habbit.

Fharoah

Aug. 6, 2009, 03:34 PM

I am so glad the surgery went well, and I just hope to get my most beloved horse in the world back to soundness, and pain free!

I really appreciate everybodies help and support!

Peggy

Aug. 6, 2009, 07:28 PM

Don't feed him when he bangs. Ever. Which I realize you may already be doing.

Star got into the bad habit of doing this when the person who kept food at the back of his stall would prep her horse's food b/c she always fed him. First she'd yell at him to stop. Repeatedly. And then she'd feed him.:rolleyes: She moved her food from the area and things improved rapidly. The person with the horse next to him gives him one treat when she arrives at the barn. He is smart enuf to figure out that he just gets the one (and not when he bangs) when she arrives and never bothers her after that.

Fharoah

Aug. 6, 2009, 08:35 PM

Yept what happened. He however bangs and claws until he gets something, is was really tough because he band his bad ringbone leg.

Fharoah

Aug. 7, 2009, 10:01 PM

Fharoah chewed off part of his cast, so still ok to leave on now has cayanne pepper and such which he doesn't like the taste of. Sergeon is hoping he won't have to replace the cast, it needs to stay on for two weeks.

WW_Queen

Aug. 7, 2009, 10:22 PM

No constructive comments relating to your horse's immediate medical condition BUT....

1. Can we see pics of your horse? :) He sounds lovely.

2. Are you paying for his care out of pocket or is insurance paying these bills? My horse has been similarly off for 2+ years (however not as complex as your guy's case) but it has been quite frustrating/expensive. I would love to do more diagnostics but can't afford to. :(

Fharoah

Aug. 7, 2009, 10:43 PM

You can see my horse if I can email photo so you can post them, because I don't know

I have been really fortunate, he has no insurance

My sergeon is wonderful, I would really like my boy to live pain free, my dream is ridding sound!

beaulilly

Aug. 9, 2009, 03:07 PM

Glad to hear Fharoah is doing so well!:)

Fharoah

Aug. 9, 2009, 04:14 PM

http://fharoahforlife.blogspot.com/2009/08/fharoah.html

here is one more I couldn't fit on

http://fharoahforlife.blogspot.com/2009/08/fharoah-i-maintain-my-confidence-even.html

Mara

Aug. 9, 2009, 05:29 PM

Aww, he's a beauty! Thanks for posting. Jingles for continued recovery and happy outcome.

Fharoah

Aug. 9, 2009, 06:13 PM

Aww, he's a beauty! Thanks for posting. Jingles for continued recovery and happy outcome.

Thankyou he is so special too me!!!!!!!!!!!!!!!!

Peggy

Aug. 9, 2009, 07:53 PM

He is indeed lovely, with a wonderful kind eye. I can see why you have worked so hard to help him.

Fharoah

Aug. 10, 2009, 08:33 PM

Thankyou he is a real sweat heart. My dream is ridding sound, even to jump him over small course like the baby greens!

Fharoah

Aug. 10, 2009, 09:14 PM

Does anyone know if once sound movement is affected by arthrodesed limb?

Fharoah

Aug. 19, 2009, 01:10 PM

Had a long visit with Fharoah it was odd. At first he was in a really good mood lots of cuddles and grooming, then he got wild spinning, kicking I could not groom had to leave the stall, which he was running circles in practaclly three legged lame, I would say 4/5 (at least) on 1.5 grams of bute, the most lame I have ever seen him in his life. Surgeon says not to put shoes back on him and not to even file his feet for acouple of months, but they are long now, and grow really fast. Then the fed him a snack of grain which he inhaled, not sure why they gave him grain, then he ate his hay totally calm and mellow and I cuddled him and he was a total sweetheart again, but he didn't quite finish his flake when he stopped eating stopped stone cold pointing his foot (not baring much weight on arthrodesed leg the entire time) he stood stone cold as if he has sleeping but I could hardly touch him he would pin his ears and bite me if I came near? So I left him. He by nature is the kindest horse in the world. I am hoping he will feel

I want to trust my vets but intuitively I feel he should be treated for ulcers even if just to air on the side of caution? Do you think I should forget about ulcers? I only want to help my horse? I don't want to overreact, I have been very polite and grateful to my surgeon yesterday included, I really trust him am just alittle concerned. Any wisdom? Also how am I going to keep him quiet for the next six months? Any wisdom is greatly appreciated!

Mara

Aug. 20, 2009, 10:21 AM

Souns like he definitely has a few anxiety issues. Who wouldn't? He's cooped up, his leg probably bothers him to some degree, and now from the sound of it he may have some ulcers. The discomfort from that is probably adding to his anxiety, perpetuating the cycle.
He's been through a lot, as have you. IMO, a course of GastroGuard is a good idea. Have your vets given a reason why they would rather not?
Also, did you ever reach a decision on the fluphenazine?

Fharoah

Aug. 20, 2009, 11:49 AM

I haven't gotton to talk my vet yet about fluphenazine. My surgeon has told me he HAS to stay very quiet, as pressent I am not even aloud to have his feet trimmed for a month or two. Surgeon wants him barefoot for six months. He has three casting sores from tripple kicking the brick walls is what his surgeon thinks. My surgeon does not use fluphenazine or reserpine ever in his practice, he prescribes ace for hand walking, but I feel in a very tough choice as I really want the surgery to work. I am going to try everything to keep him calm without drugs, if failed herbs, ace and last resort my regular GP may be willing to give fluphenazine but people in my life are not going to forgive me if anything goes wrong so it is a tough one.

Fharoah

Aug. 24, 2009, 12:33 PM

Fharoah had a smooth surgery and smooth recovery. He had his collateral ligaments cut and the articular cartilage debribed and his pastern joint was stablized with plate and three screws. He was weight baring the leg and standing fairly square for the first week after surgery, however very lame at the walk. He would get wired and pace and wear and buck and apparently the first horse to tripple kick the brick walls troting small circles in 12x16 stall less than a week after surgery. Week two, still at the hospital he was baring less and less weight on the leg pointing his toe and had increased digital pulses in the left front, still far to three legged athletic at times. Cast sores were discovered and his bute was increased to 1.5 grams twice a day (3 grams per day). I am nevous about ulcers. On day 14 he got the cast removed and radiographs look good so he was discharged on Friday.

On Saturday he was rearing and spinning so I started him on low dose of ace and he was good, he was again far to three legged athletic so I upped the ace today, still a low dose but it is so early still. I am going to talk to my vet about fluphenazine when he changes the bandage later today, however due to the possible side effects my surgeon will not use long term sedatives, and I am not very hopeful my GP will either. My surgeon did say it was imparative that Fharoah stay quiet and I am really nervous he will mess up the surgery playing too hard. He seems really happy to be home and has a very quiet stall bound buddy yet continues to be way too perky.

Any advise is greatly appreaciated!

Fharoah

Aug. 25, 2009, 12:15 PM

Fharoahs bandage today at 5pm, no heal sores were noticed. At 7pm he had had bleeding sores on both heel bulbs of his right front worse on the medial side, with some swelling. My vet looked, considered them bandage sores, did not wrap his heal, just applied furacin, he was not concerned. I am most likely just being an over paranoid owner but I am worried about possible infection.

Fharoah has pretty ugly large moderate casting sore over his cannon bone two yucky casting sores on his pastern, and now one on each side of his heal which was deep on the medial side. There was so much much excreeted in three days that my vet wants to rebandage on Wednesday. Poor guy is quite lame but other wise in good spirits.

Fharoah came home Friday night, on Saturday he was rearing and spinning so I started him on a 1/4 scoop of ace granules, he was good on Saturday but was more exberant on Sunday so on Monday went to 1/2 scoop of ace, he is being good, I hope he lasts on that dose for a while. What I find is the ace works for a while, it stops working, I up the dose eventually increasing the dose has no effect. Hopefully I can get a good month on of the ace, I am still leaning towards a dose of fluphenazine depends on how he does. My vet is not entirely comfortable with that drug though, but did not say no.

Peggy

Aug. 25, 2009, 10:18 PM

Thank you for the updates. Being back at home with you in his comfy familiar environment should help him both mentally and physically. I am glad to hear that the ace is helping. Maybe it will get him over the hump and he'll start to settle.

If the furacin doesn't help, you might talk to the vet about something like alushield that sometimes helps wounds like overreaches (heel grabs) to heal.

Would he be happier with something to occupy him in his stall. Maybe a toy, one of those things you put food in, or even a nibble net so he can spend more time munching without eating so much he gets fat. The nibblenets have been discussed on other threads here.

Fharoah

Aug. 26, 2009, 01:43 AM

I should get him a toy as he may like it. My yearlings are altering and playing stall bound buddies they both have 12x20 feet. That may be too much room in the past Fharoah would go stir crazy in a 12x12 wearing and spinning and kicking the walls and troting on the spot so the tighter turns really didn't help this was while on ace and reserpine. When I asked my surgeon he seggested 12x16 to 12x18 feet so I may try and make it alittle smaller. It is a hard one because smaller space he tends to just turn tighter. My boy justs loves to play. He has a very good appetite. He is getting beet pulp and vitamin mineral supplement only because it the only way he will eat bute. Otherwise I have to syringe it and he throws his head up and it is really tough to give twice a day. It is difficult because I prefer to feed him nothing more than base vitamin mineral supplement.

Fharoah

Sep. 7, 2009, 12:08 PM

Fharoah scared me yesterday did not go pee from 7pm last evening as his stall has remained dry. My GP said don't worry call me if he hassn't peed by the morning. My surgeon said if he haddn't peed by evening do bloodwork and diaretics. At 3pm he tried to go pee but it appeared as if he couldn't. At 4pm he peed. He is eating very well both hay and grain. He is sensitive on both sides of his loins. I am concerned about the possiblity of ulcers on the other hand he has not lost weight, he has gained weight, and is eating very well! He appears in good spirits today and his stall was wet.

Fharoah

Sep. 12, 2009, 12:12 PM

Just thought I would update on Fharoah he has shown tiny bit improvement in his walk is still quite lame. He seems worse when he goes stir crazy which is happening more and more. His stall buddies are so quiet but they just watch him be a nut. He rears, he bucks, he spins, he kicks, he tries to canter and looks very lame and awkward. He is on a ton of ace three times per day which is minimal to no help really. Reserpine was previously been tried both IM and orally both at a low dose then a larger dose had no effect. I have tried every calmer they do nothing. I am going to beg my vet for fluphenazine but it is unlikely he will prescribe it as he doesn't like the possible side effects. My surgeon will not use fluphenazine, so I am likely out of luck. He seems to get better and worse but was walking better for sure in video clip I took on Wednesday. He looked worse this morning but it is hard to really tell in his stall so will watch closely when I take him out for bandage change today. If he is worse that is very bad but he just seems to really limp sometimes then almost walks out of it and appears much better. To an extent all I can do is hope and prey, it is scary!

Fharoah

Sep. 12, 2009, 12:20 PM

Oh ya he is off grain other than tiny bit of beet pulp for powders 1/3 cup supplement 3 times a day he is on filler hay, he is on magnesium oxide as I was told it may enhance the ace I can't say it does anything he is also getting selenium crumbles as we live in a selinium deficient area.

Fharoah

Nov. 3, 2009, 12:22 PM

Fharoah is getting 3.5ml of acepromazine injectable 25mg/ml orally over half a cut of soaked peet pulp with a minimal vitamin supplement. He has been a preety good boy the past few weeks. He is still lame at the walk but has improved since surgery so I am very curious for his follow up radiographs on Friday Morning! Jingles would be greatly appreciated!

bonds

Nov. 3, 2009, 01:57 PM

Will keep my fingers crossed your boy's follow up shows good results. Sounds as if he is settling into his current situation.

Are you also treating for ulcers just in case?

dwblover

Nov. 4, 2009, 10:31 AM

Jingles!:)

Fharoah

Nov. 4, 2009, 12:36 PM

Thankyou, I really appreciate all the support! I am nervous I no he has improved and my surgeon says he expects him to still be lame at the walk. I am just really hoping!!!!!!!!!!!

Fharoah

Nov. 6, 2009, 03:27 PM

Everything looks good with Fharoah, he did break two screws so I will not be able to remove them or apparently it would be really hard. He spends three more months doing the same how boring oh well, handwalking is historically a nightmare anyways (drugs don't help). No increased turnout better since he canters his stall and historically can still run around on even if very lame. I can't believe he broke a screw. He is walking better still lame at the walk but so much better than he was my surgeon expects him to still be lame at the walk. The joint is partly fused on the medial side there is still joint space on the other side but that should go away. So were on the right track. Several times I emailed my surgeon a video clip I was worried about Fharoah having increased lameness and wondering about radiographing early, he saw no need. He seems positive and doesn't appear to consider the broken screws an issue.

Thankyou all for your support!

Fharoah

Dec. 20, 2009, 01:12 PM

Fharoah been pretty quiet lately with 6ml of 25mg/ml acepromazine twice daily. He is rather depressed at times, as it pours rain here I am pretty grumpy too. The waiting hoping and insecurity is really depressing at times. He is walking better still slightly asymetrical and shorter on turns but no limp. He is still in a 12x20 which surgeon approved it is still very hard. I am hoping Fharoah will at least be ready for handwalking by February recheck. As he was head bobbing lame at the walk on discharge in August he has been improveing so I can really hope he is walking sound by February, the two broken screws may slow thing down so just hoping and soundness should be approximently a year could be less could be longer so just waiting and hoping for continued improvement.

mvp

Dec. 20, 2009, 02:53 PM

So good to hear a pretty good update!

BTW, have you and your vet talked about Osteon? It's a feed made by Platinum Performance that contains a bioavailable form of silicon. My vets recommend it for fractures.

I'm not sure whether arthrodesis surgery "counts" as a fracture situation--where you would like to accelerate bone growth. But the broken screws might mean you'd want something like that.

I may have mentioned this before. If not, ask your DVMs.

I'll look forward to hearing that Fharoah can hand walk!

Fharoah

Dec. 20, 2009, 03:03 PM

mvp

Dec. 20, 2009, 05:40 PM

Check out the thread on infrared therapy and magnets.

We made a magnet patch for a mare healing from a nasty pastern fracture and problems with the bone not correctly growing around screws put in by a surgeon.

It was my DVM's idea.

If Fharoah will tolerate a wrap on his bionic leg and you have a barn staff that will use it, I don't think you have much to lose by trying it.

Fharoah

Dec. 20, 2009, 06:32 PM

I am openminded for sure anything to help my boy! Is this mare at your barn have a fusing pastern?

Peggy

Dec. 20, 2009, 08:30 PM

Thanks for the update. It sounds like he's making decent progress. Keeping my fingers crossed and jingling for continued improvement.

Fharoah

Dec. 20, 2009, 10:48 PM

My surgeon says he is optimistic despite the two broken screws so I am just really hoping he will have positive progress for February and handwalking or something as I feel total stall rest has been hard on him mentally.

Fharoah

Dec. 21, 2009, 01:04 AM

Thanks for the update. It sounds like he's making decent progress. Keeping my fingers crossed and jingling for continued improvement.

Thankyou Peggy! I just love this horse so much I really really don't want him to be in pain, he is the best he really deserves to be sound so I am just really hoping this surgery will work!

Fharoah

Jan. 30, 2010, 12:56 PM

Recheck on Wednesday afternoon very nervous. It is very hard for me to tell based on stall rest how he is doing so this will be very interesting I am alittle bit scared but really really hoping.

Roxx

Jan. 30, 2010, 06:32 PM

Crossing my fingers Pharoah :)

Peggy

Jan. 30, 2010, 08:19 PM

Crossing all digits, jingling, and will be thinking of you and Fharoah on Wednesday!

Fharoah

Jan. 31, 2010, 12:43 AM

Thanks Peggy and Roxx, I is such special horse I really really want to give him a chance at being sound!

Roxx

Feb. 4, 2010, 07:56 AM

Anxiously awaiting news...how did Fharaoh's re-check go?

Fharoah

Feb. 4, 2010, 08:46 PM

My surgeon was all positive. Fharoah will start five to ten minutes of hand walking per day and gets small paddoc to be enlarged every month until he is on full turnout over the next six months. He will be re-evaluated in July and if fully fused and sound I can start ridding him. He was walking well in his exam, we did not trot but he did break into a trot a few when loading and my heart sank at how lame he was. My surgeon says that is ok, there is almost full joint callapse, partial fusion. Things are progressing slowly but well, I really really hope he continues to improve over the next six months and he comes fully sound!

Thankyou you all for your support!

Peggy

Feb. 4, 2010, 09:23 PM

Yeah! I tend to feel better after getting a positive report from the vet even tho I've been watching the horse all along and hope you feel the same way. Onward!

Roxx

Feb. 4, 2010, 10:06 PM

Great news Fharoah :) Sounds like good progress is being made. I am also seeing a light at the end of the tunnel as well for my mare. She is scheduled to go into a small paddock about a week from this Sunday so fingers crossed her stall rest journey will be over!

mvp

Feb. 5, 2010, 06:49 AM

That's great news!

For the rest of us learning about this surgery and it's rehab from your experience, can you answer a couple of questions?

At this point, how much pain do think Fharoah feels in his day-to-day life in prison....no, wait, I mean his stall? And remind me, how many months out is he?

I'm just asking because severity of pain over time after surgery is something that has kept me from considering arthrodesis for a horse that it might help in the long term. I don't know anyone who has done it, so I can't make real sense of my vet's warning that "it hurts a lot for a while."

I know you have done everything possible to make Fharoah comfortable, so please don't take my question as a criticism of your decision to try arthrodesis. For a young horse who otherwise loves you and loves having a job, it makes more sense than the case I'm thinking about. Here the horse is much older. That's why the "time spent in pain" (as well as the very long rehab that will rot the rest of his old man body) become serious considerations for me.

Thanks for your help, and especially for allowing the rest of us to follow Fharoah's progress. Best wishes to you both!

Fharoah

Feb. 7, 2010, 08:17 PM

Today was our third five minute hand walk and I felt he was walking better today than Friday.

Fharoah

Mar. 16, 2010, 12:27 PM

Fharoah has now 40 feet of turnout, he is alloud 80 but I haven't done that yet. He is troting and cantering quite happy. I am apprehensive he could hurt himself but surgeon wants him to have this room and he is alloud to run. Seems like one extreme to the other, we are still only walking ten minutes daily. Ultimately I am just trusting my surgeon and hoping he doesn't hurt himself. I am happy to see him out

Peggy

Mar. 17, 2010, 02:58 AM

Great news. I bet that he is happy to be out as well.

Fharoah

Mar. 17, 2010, 01:04 PM

I am a bit freaked but also happy. I think I would like to bubble wrap him in an air matressed stall and paddock he wants to run. I can't stop him so just putting things in gods hands I mean surgeons I trust surgeon and what more can I do he already had six months heavily sedated stall rest can't do that forever. Fharoah happy so I am just keeping an eye on him and crossing my fingers!!

Fharoah

May. 17, 2010, 11:37 AM

Our recheck is Wednesday June 9th at 3PM. I am excited and nervous and really hoping. I have felt really positive about the way he has been walking. I nice sound heal first slapping walk he seems really solid and consistent. Fingers crossed!

Fharoah

Jun. 4, 2010, 12:29 PM

Fharoah had his recheck on Wednesday June 9th at 3pm. His pastern is fusing well and my surgeon found no other abnormalities. He was very happy with his feet. Three more months of hand walking was recommended. He currently has 60 foot x30 paddock plus 12x20 stall in and out at liberty all day. I feel really bad on this I want to give him unlimited turnout. I am taking him for two five minute hand walks with 30 minutes hand grazing and grooming thus spending 2 hours a day out of his paddock and stall area. I am doing a blood panel and mineral analysis on Wednesday just to make sure and then hopefully starting him on previcox for the summer he currently gets bute at times. I am also going to add leather pads, I may go to shock absorbent but going to try leather first as it breathes.

I had my surgeon submit his films to Washington State university for a second opinion. Also my contact at NCSU is going to have the orthopedic surgeons look at them for me.

Fharoah

Jun. 12, 2010, 06:40 PM

Fharoah also gets infored light therapy and massaged every monday. He has a buddy live next to him at all times.

Peggy

Jun. 12, 2010, 07:43 PM

Sounds like a pretty good update. He has more room all the time than Star does in the paddock that I use as a turnout, if that makes you feel any better. Ask you farrier about leather pads. They used to use the all the time down here but there may be something about them holding moisture...

Fharoah

Jun. 12, 2010, 09:29 PM

My farrier recommended leather pads and my surgeon agreed. Should I be concerned?

Peggy

Jun. 12, 2010, 10:24 PM

My farrier recommended leather pads and my surgeon agreed. Should I be concerned?Not in that case.

ljc

Jun. 13, 2010, 01:11 AM

Kayla - Congrats on a good report!!!!

Fharoah

Jun. 13, 2010, 02:20 AM

Thank you Peggy and ljc!

ljc

Jun. 16, 2010, 01:53 AM

Hang in there!!! Really.

Fharoah

Jul. 17, 2010, 01:39 PM

Fharoah seems to be improving, he likes his new shoes and leather pads. Didn't get my opinion from WSU but through the surgeon I am using have just submitted his films down to CSU to be reviewed by one of the top orthopedic surgeons!

Thank you all for your kind support means allot to me.

SouthwestRerider

Jul. 17, 2010, 07:24 PM

Fharoah

Jul. 17, 2010, 08:48 PM

Thank you, I do have some regrets along the way in retrospect would have done some things differently. In pressent tense I am just trying to get my boy happy and comfortable. Fingers crossed he has great boarded certified surgeons helping him!

Peggy

Jul. 17, 2010, 09:13 PM

Good news. Sounds like things are headed in the right direction.

Mara

Jul. 17, 2010, 09:30 PM

Thank you for the update! I just read the whole thread- not realizing it started ( the thread, not the problems) over a year ago, and am quite amazed at your devotion to this horse. Keep on keeping on, and lots of jingles for your boy. Hope to hear really good news soon.

I've been following since last year, and I agree. Any horse would be lucky to have her for an owner. She's really put herself out there for him.
She posted a pic a long while ago. He really is a knockout!

ljc

Jul. 18, 2010, 01:49 AM

We're all thinking of you Kayla. You've hung in there like a trooper all this time -- and there will be a happy ending, I just know it. Hugs.

Fharoah

Jul. 18, 2010, 03:29 PM

We're all thinking of you Kayla. You've hung in there like a trooper all this time -- and there will be a happy ending, I just know it. Hugs.

Thanks but I would say Fharoah deserves the golden star, he is one in a million I once had an old time judge tell me that!

Fharoah

Aug. 7, 2010, 07:05 PM

http://www.facebook.com/profile.php?id=1459808493#!/photo.php?pid=1364603&id=1514340090&ref=fbx_album

http://www.facebook.com/photo.php?pid=1364603&id=1514340090&ref=fbx_album#!/photo.php?pid=1331350&id=1514340090&ref=fbx_album&fbid=1511237670274

TheOrangeOne

Aug. 7, 2010, 07:17 PM

Looks like your pictures are set to private- they won't work for me. I would love to see them!

Fharoah

Aug. 8, 2010, 12:50 AM

http://picasaweb.google.ca/kayladrummond/20100725FharoahJuly25?authkey=Gv1sRgCK2UxIzhupCYbw #5502896245461338642

http://picasaweb.google.ca/kayladrummond/20100725FharoahJuly25?authkey=Gv1sRgCK2UxIzhupCYbw #5502896302636112770

http://picasaweb.google.ca/kayladrummond/20100725FharoahJuly25?authkey=Gv1sRgCK2UxIzhupCYbw #5502896367251403474

Fharoah

Sep. 4, 2010, 03:49 PM

[My vets just think it is going to take longer. Fharoah is happy, I get allot of compliments on him. I spend lots of time with him also an hour in the morning and an hour in the evening minimum. I also have a some great consults including Roods and Riddle so we have a good solid plan of action. Fharoah has the will and desire and great specialists I am listening to. Also we blocked his foot and nothing changed. He flexes negative in coffin joint and fetlock and they radiograph perfect. So we are still working on the pastern and will decide further in April.

Peggy

Oct. 11, 2010, 07:02 PM

Thanks for the update with good news. It sounds like things are heading in the right direction, however slowly.

Quinn

Oct. 11, 2010, 07:13 PM

That is fabulous news!!!

http://community.webshots.com/user/ballyduff

ljc

Oct. 12, 2010, 01:44 AM

Now would you take a deep breath and give yourself permission to RELAX for a bit!!! Kayla, you done well. I'm proud of you.

Fharoah

Nov. 8, 2010, 09:58 PM

I have just ordered previcoxx for Fharoah. I does okay on bute but I want to try him on an alternative. He can go without but I think he is generally more comfortable with.

Fharoah

Nov. 28, 2010, 01:00 PM

https://mail.google.com/mail/?ui=2&ik=312dabc613&view=att&th=12c906d86a7617fc&attid=0.1&disp=inline&realattid=f_gh1ce06t0&zw

The latest trot I saw from Fharoah looked to have shown great improvement. We are hoping he will be all fused and sound for his re-evaluation in March!

Quinn

Nov. 28, 2010, 02:08 PM

Exceptional!!

http://community.webshots.com/user/ballyduff

Fharoah

Nov. 28, 2010, 04:09 PM

[QUOTE=Quinn;5250394]Exceptional!!

Thank you! We you able to see the picture not sure it the link works

Fharoah

Nov. 28, 2010, 05:52 PM

https://mail.google.com/mail/?ui=2&ik=312dabc613&view=att&th=12c94aa64aed3b52&attid=0.1&disp=inline&realattid=f_gh2inlae0&zw

Fharoah

Nov. 28, 2010, 05:54 PM

https://mail.google.com/mail/?ui=2&ik=312dabc613&view=att&th=12c94aa64aed3b52&attid=0.1&disp=inline&realattid=f_gh2inlae0&zw

Quinn

Nov. 28, 2010, 07:39 PM

No, can't see the pictures and would love to.

http://community.webshots.com/user/ballyduff

Fharoah

Jan. 31, 2011, 02:00 PM

Here is a cute picture http://fharoahforlife.blogspot.com/search?updated-min=2011-01-01T00:00:00-08:00&updated-max=2012-01-01T00:00:00-08:00&max-results=1 I discovered Fharoah would get claustrophobic in the barn but he loves having low stalls he is so quiet with his friend next to him.

Fharoah has been cleared for turnout again. He is happy and quiet. He is still wearing wide webbed shoes with leather pads. He continues to very slowly improve. Seeing him trot I can see good progress this winter although still not sound. Fharoah gets rechecked early April, can't wait for this winter to be over. In the meantime I keep him on previcoxx which keeps him looking comfortable!

1horseRachel

Jan. 31, 2011, 08:37 PM

Really cute horse. Glad he's feeling better

JackieBlue

Feb. 26, 2011, 01:31 PM

Please forgive my ignorance if I've missed this somewhere, but does Fharoah have broken screws in his pastern now? Broken in 2 pieces or more? Are all broken pieces remaining or only one piece of each screw?

Fharoah

Feb. 26, 2011, 02:14 PM

The broken screws are in place one is broken the other is bent it sucks, but I have chosen to trust my vets and have had some additional consults from top orthopedic surgeons.

JackieBlue

Feb. 26, 2011, 02:54 PM

I have personally had broken hardware in my own leg. Unfortunately, multiple times. At times a couple of screws, one screw or all screws and a shifted/bent plate, femur and tibia. I've had THE top complicated fracture surgeon on the east coast, if not the whole US, tell me that broken screws don't cause pain. Um, bullshit. They hurt like hell. I've had hardware failure with unhealed fractures and I've walked with broken screws with healed fractures. Going through life with broken screws in an otherwise healed leg HURTS. Some people are more sensitive to hardware issues, some hardware is more mobile, etc. I'm sure the same is true for horses. My most recent bout with broken screws has only just recently begun to improve. I had a 13 inch plate and 13 screws removed from my tibia on January 10. The buried halves of 3 broken screws are still in there, but without the other broken pieces causing motion in the screw holes I'm like an entirely new person. The pain of broken screws, at least for me, wasn't felt all the time, but if I took a bad step or went from standing to walking or sometimes even just moved my leg a certain way.... OH MY GAWD the pain was like someone slamming a sledgehammer into my shin! And believe me, I have a massive pain tolerance and have even walked on a badly broken leg more than a few times. (LONG story. Well, stories.)
In summary, I've had broken screws multiple times. Every time surgeons have told me, "Oh no, that's not the source of your pain", but since I also have a history of osteomyelitis (MRSA and Staph epi) the surgeons always want to get in there and biopsy, so hardware removal is a no brainer as long as they're going in. EVERY STINKIN TIME as soon as the offending hardware and broken pieces are extracted I feel 100% better! I know of what I speak. Broken screws can be miserable and the intermittent aspect of the searing pain can seriously drive you crazy and cause a good deal of anxiety! If you've ignored all the rest of what I've typed, please heed this: MOTION INHIBITS FUSING AND BROKEN SCREWS ARE PRONE TO MOTION!

*Hops off soap box* I certainly understand your reluctance to put your horse through another surgery, but if he doesn't come sound please keep in mind that those screws may very well be at the heart of the issue.

Fharoah

Apr. 21, 2011, 12:03 AM

I was hesitant to post this. Everyone knows I have a horse with a fusing pastern. He had been rechecked a few weeks back and pretty much what I expected he has improved clinically which is supported by his radiographs. I spoke candidly to my surgeon told him I was worried about quality of life. Surgeon was insisting the is not suffering and he says he is confident he is fusing and that fusion will complete even he knows I am quite worried. Apparently at this time it is turnout to stimulate fusion. Fharoah walk trots and canters, rolls he is the most personable horse in my barn, actually the rest of the horses are grumpy. Fharoah is also obsessed with food. What I do is I hand graze him an hour in the morning and before dark pretty much every single day. I also groom him he is a sweet heart and I love being with him. So on the advise of the surgeon I use and another orthopedic surgeon whom is #4 in the country I think I will give him more time.

He is currently wearing wide webbed shoes with rolled toes and leather pads. My farrier uses a packer and he has no thrush. But I contemplate should I continue with the shoes or try him barefoot. I am worried about his coffin joint which is currently normal. Are there any supporting supplements that are proven to help prolong the life of his other joints.

Here is a picture if my link works http://lh6.ggpht.com/_RoqnF325Y2Q/Ta-wP7IXcMI/AAAAAAAAd8Q/ptwvPk2Mtos/s1600-h/grass%5B2%5D.jpg