A big mare in her late teens with no history of front leg unsoundness is suddenly lame on one front leg, moderate to severe, 2-3 on 5 point scale, at trot. Sound and comfortable at walk, makes sharp turns no problem, no toe pointing, walks down hill no problem. No improvement after a month.
Vet comes. Mare is reluctant to flex at all on lower joints, and is blocked.
1) digital plantar -- still lame
2) ablaxial (sp) sesamoid -- sound
Blocking like that it could hundreds of things:
Coffin joint, pastern joint, collertal ligaments of either, sesmoidian ligaments, distal sesmoid bones, distal deep flexor tendon, the list goes on and on.
And any time a horse goes suddenly lame I still never rule out an abcess, even if it didnt block to a PDN (sometimes the PDN wont get all of the toe region).
I would not discount a possible abscess given the time of year and the symptoms you describe...but the soundness at a walk kind of gives me pause on that.
Nerve blocking can be a great tool, but in my limited experience, it can also lead you astray pretty easily.
I would be inclined to get radiographs done.
There's NO indication of any possible puncture from below correct? One of the things that kind of floated into the back of my mind was an infection within the hoof capsule as a result of a possible puncture. But totally playing guess the issue here.
I'd really want rads.
A good horseman doesn't have to tell anyone...the horse already knows.
Jeez, it could be anything. X-rays, response to hoof testers, exam of the sole and frog?
A big mare in her late teens who flexed positive in multiple areas wouldn't surprise me. Might be a red herring. I'd want to zero in on the unsound part of the limb and given all that's going on from the fetlock on down, I'd think a diagnosis without films is going to be tough.
Xrays showed roughened bone around the back of the pastern suggestive of distal sesamoid ligament damage. That is roughly the area that blocked sound, plus this horse was seen cavorting around in the deep snow in the days before pulling up lame.
No ultrasound was done, and the vet recommended conservative treatment with bute and light turnout for a few weeks.
Anyone had experience with distal sesamoid ligaments? Apparently the prognosis is fairly good -- and with this older mare the goal is trail/light riding or worst case scenario, pasture sound.
I had a gelding that tore the right fork of that ligament. He had stall rest and handwalking... I can't remember. 6-8 weeks? He was able to come back from it. There was ultrasound involved as well as some shock wave therapy once or twice. He was fine when it healed.
First, say to yourself what you would be. Then do what you have to do. ~Epictectus