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  1. #1
    Join Date
    Aug. 2, 2009
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    Tennessee
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    Default Troublesome On Again, Off Again Front Limb Lameness

    Alrighty, I'm looking for ideas, opinions, a listening ear, pretty much anything at this point. Sorry it's a bit on the long side.

    I've got a 14y/o TB Gelding. Has been ridden lightly for the last 4 years since I've been in college. I brought him back into work in December and took him back to school with me in Feb. He was doing fabulously and then came up lame around Easter. Had a vet out to look at him from the Vet School and he blocked out completely to the PD. We removed the shoe and a found a small bruise, under his shoe.. What can I say, he's talented. Anyways, put him on stall rest, wrapped and packed with Magic Cusion as per vet's instructions. After about two weeks of stall rest and limited turnout, farrier determined that shoe could go back on. He was turned back out.

    He got better to a point but then showed no improvement. Sound on a straight line on both hard and soft surfaces but quite lame on a circle to the left. Brought him back home at the beginning of May. After finals were over, I brought him to my normal vet so he could have a look-see. Blocked the coffin joint and he went off sound. Injected coffin joint and suggested some shoeing changes after taking x-rays (joint normal, just a touch long in the toe. Wanted breakover moved back). Saw no change from the injections. Had his feet done two weeks after the injections. Horse went sound a few days after having his feet done. Sound for 3weeks then came up lame again a little over a week ago.

    Brought him back to vet Fri. Blocked off to the PD again. Vet had been hearing good things about Tildren being used in regional perfusion and wanted to give it a try. Injected Tildren via regional perfusion. We're 4 days post Tildren, still not seeing any change. Not really expecting to yet as I was told it may be 8-10days before we see anything.

    So there's the history so far . Any ideas? Similar situations? Experience with Tildren via regional perfusion?

    I'm at a loss because his x-rays are clean but there is obviously SOMETHING going on in that foot! This was supposed to be my fun spring/summer of showing before beginning vet school so I'm a bit frustrated.
    "There is no secret so close as that between a rider and his horse." - Robert Smith Surtees



  2. #2
    Join Date
    Sep. 27, 2000
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    Southern California - on a freeway someplace
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    Default

    My horse who blocked the same way and radiographed clean turned out to have strained collateral ligaments (ones b/w P3 and P2). Diagnosed via scintigraphy and MRI.

    You can read more in the blog linked in my signature. The prequel to the blog is that he would come out ever-so-slightly NQR in front from time to time for roughly six months before the injury. He had a series of strange abscesses in front that the vets at the hospital told me could be related to irritation from the ligaments.
    The Evil Chem Prof



  3. #3
    Join Date
    Nov. 10, 2005
    Location
    Va
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    3,867

    Default

    I will be interested in what others have to say as I am going thru this also. I have a vet appointment next Monday for my mare to evaluate for sporadic right front lameness that I am pretty sure has something to do with her foot. Good luck with your horse.



  4. #4
    Join Date
    Aug. 2, 2009
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    Tennessee
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    Default

    Peggy - I have been wondering if maybe it was something soft tissue. I'll definitely talk to my vet about the possibilty
    "There is no secret so close as that between a rider and his horse." - Robert Smith Surtees



  5. #5
    Join Date
    May. 6, 2006
    Location
    Warren County, NJ
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    Default

    Been thru the same in the past.
    Sound straight line, sound hard ground, off circle on hard ground, lame circle on soft ground. In his case it was collateral ligament tear, not visible on X-rays, only a very powerful ultrasound may pick up on it close to coronet band, scinti will light up.
    We did not do an MRI, but MRI would also give you a definite answer.



  6. #6
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    Jan. 1, 2008
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    Quote Originally Posted by Peggy View Post
    My horse who blocked the same way and radiographed clean turned out to have strained collateral ligaments (ones b/w P3 and P2). Diagnosed via scintigraphy and MRI.
    Yep...a simple ultra sound may find what you're looking for. I'd start there.



  7. #7
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    Sep. 27, 2000
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    Quote Originally Posted by Go Fish View Post
    Yep...a simple ultra sound may find what you're looking for. I'd start there.
    My understanding is that an ultrasound may help with collateral ligament diagnosis only if the injury is at the upper end of the ligament. If the injury is within in the hoof capsule ultrasound won't help much, if at all. But it might be worth a try, given the relative cost and hassle of ultrasound vs scintigraphy/MRI.
    The Evil Chem Prof



  8. #8
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    Quote Originally Posted by Peggy View Post
    My understanding is that an ultrasound may help with collateral ligament diagnosis only if the injury is at the upper end of the ligament. If the injury is within in the hoof capsule ultrasound won't help much, if at all. But it might be worth a try, given the relative cost and hassle of ultrasound vs scintigraphy/MRI.
    I guess I should have elaborated...it may not be in the hoof at all. I'd start looking elsewhere.

    I had a horse that blocked sound for hoof issues. Turns out he had a suspensory tear. He'd had about 4 weeks of rest, so the suspensory was feeling better. The vet never could quite figure out why the hoof blocked. Absolutely nothing wrong with it.



  9. #9
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    Sep. 14, 2002
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    Azle, Teh-has
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    stick the entire leg, up to the knee, in an MRI.
    MRs are expensive but with what you have already done it (or will be doing in the coming months) it would have been more than 1/2 paid for.

    My horse tore his suspensory off at the origin and put a hole is his sesmoidal lig. He would trot out sound when we blocked his navicular. Turned out not to be the foot at all.
    go-figure.
    With the above injuries he was never more than a grade 1 lamesness and we could only get him to head bob on the circle.

    roaming/ongoing lameness is almost ALWAYS soft tissue.
    http://kaboomeventing.com/
    http://kaboomeventing.blogspot.com/
    Horses are amazing athletes and make no mistake -- they are the stars of the show!



  10. #10
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    Jun. 28, 2010
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    I had the same situation with my mare, on and off , and when she was off it was barely noticeable. We injected the coffin joint (which was filled with fluid) and thought that was it. After being blocked it look like something with the navicular, but an MRI revealed a collateral ligament tear. She's on her fourth month of stall rest. The treatment is really going to depend on an accurate diagnosis. Better in the long run to find out exactly what you're dealing with.

    <You can read more in the blog linked in my signature. >
    When I try to bring up your blog, I just get a page not found.. would love to read about your journey...



  11. #11
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    Sep. 27, 2000
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    Quote Originally Posted by silvermar View Post
    <You can read more in the blog linked in my signature. >
    When I try to bring up your blog, I just get a page not found.. would love to read about your journey...
    That's fairly odd as it's just my COMH page. Add further oddness ensued when I tried to post it as an attachment and discovered that my premium membership had evaporated. Maybe they're trying to tell me something. But, where there's a will (and a .Mac account) there's a way.

    Link to lameness blog. The links do work, but the "Read More" link at the end of each blog post don't have any more (but they do go, rather eerily, to my COMH blog that the signature line didn't)

    And video proof that he did indeed come back, spookily posted a year ago to the day.
    ---------------
    And link in signature now fixed in case anyone thought that either silvermar or I was crazy.
    Last edited by Peggy; Jul. 9, 2010 at 01:52 AM. Reason: note about fixed link
    The Evil Chem Prof



  12. #12
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    Dec. 29, 2005
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    Ojai, CA
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    Default

    Another vote for soft tissue injury. I went through a similar quest while trying to diagnose my gelding's on again/off again lameness. Finally did an MRI (after ultrasound showed nothing) and learned he had a DDFT in the left front and an impar ligament tear in the right front. Neither tear could have been seen in an ultrasound. There's so much that can go wrong inside the foot and it's so difficult to get an accurate diagnosis w/out an MRI.

    Good luck.
    R.I.P. Ollie (2007-2010) You were small in stature but huge in spirit. You will never be forgotten.

    Godspeed, Benjamin (1998-2014). A life well-lived. A horse well-loved.



  13. #13
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    Aug. 2, 2009
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    Tennessee
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    Out of curiosity, for those of you who got MRIs, how much do they typically cost?
    "There is no secret so close as that between a rider and his horse." - Robert Smith Surtees



  14. #14
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    Sep. 14, 2002
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    Quote Originally Posted by eventingVOL View Post
    Out of curiosity, for those of you who got MRIs, how much do they typically cost?

    300 dollar deductible with insurance.

    otherwise they are 1800-2K.
    It sounds like a lot but in the end. Totally worth it. Better than beating around the bush for months on end.

    for anyone without insurance---if you have a sport horse, insurance is completely worth it for this reason alone. I insure my horse for a small amount (5K) just to get the major medical/surgical benefits. I saved 7.5K last year.
    http://kaboomeventing.com/
    http://kaboomeventing.blogspot.com/
    Horses are amazing athletes and make no mistake -- they are the stars of the show!



  15. #15
    Join Date
    Jun. 28, 2010
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    17

    Default

    $2000. for the MRI. They did both front legs for comparison. We're getting a second MRI done next week to see where she is; if she's ready to start rehabbing . The second MRI is $1000. since they only have to do the one leg. My insurance covers 60% of the diagnostic tests, but luckily 100% of the stem cell. Costly, but worth it so you can get the correct diagnosis. For instance, they first thought my mare had a navicular problem due to how she blocked. The treatment for that is totally different than the treatment for the torn ligament. We would have just increased the damage.

    There is also a company, I think its Care Credit, that provides a payment plan for medical if you don't have insurance. I think its no interest for the first 6 months, then a really high interest rate, but it might provide an option if anyone needs it.

    Peggy, thanks for fixing the link. I was beginning to think it was me



  16. #16
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    I, or rather my insurance company paid $1700 for Star's MRI. Both front legs. They even paid the $50 for stabling (he stayed overnight b/c he also had a scintigraphy). The deductible was long paid at that point with all the diagnostics. We did manage to get the collateral ligaments on the same claim as the original high suspensory in the RF so I didn't end up paying four deductibles that year. There were two other claims--one for a mystery illness that lasted about 24 hours and another for an impaction colic. The latter put me over the $7500 limit for the year and occurred roughly a week before we would have rolled over into another year and another policy and thus another $7500.

    The shockwave was about $900 plus call charges and sedation and the insurance paid that. They did not pay for the IRAP which was about $1800.
    The Evil Chem Prof



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