Your MRI Stories? Update - New CT Technology Post 23 and 24
I am considering this on a horse where the vet cannot find anything using multiple ultrasounds, left front probably right below the knee.
What is your experience with them? Your recommendations? I'd like to have a bit more info before spending that amount of money.
Last edited by Whodat; Jul. 21, 2012 at 06:22 AM.
Mine unfortunately is not a good one....he had problems with the anesthesia...ended up shattering a bone in his knee when coming out from the anesthesia because he hyperextended the knee when he tried to stand. Due to the location of the bone, he was able to be put on stall rest for a couple of months and then retired. He is trail sound for light riders so he was retired and is now my vet's kids' horse. He must be out 24/7 to keep him moving and minimize the negative impact of the arthritis. I was very lucky that the situation was an option. If not, he probably would have been euthanized.
The MRI did determine the initial problem (in the foot of a different leg) but honestly not sure I would ever do it again. Anesthesia is just such a risk.
I would do it again, The MRI let us see the whole picture of the injury where the x rays and ultrasound did not show us all that was going on, it helped us change the treatment plan though not sure it will help the outcome in the end. But I believe it was worth every penny and it was just under 2000.00 with all the incidentals included , Just the MRI without the drugs or reading ect was 1300.00
When you are young and fall off a horse, you may break something. When you are my age and fall off you splatter. Roy Rogers
Keebler had one and it diagnosed the problem (navicular bursa rupture with small DDFT tear down int he foot) absolutely correctly, allowing a surgical treatment that returned the horse to soundness. He tolerated the procedure just fine.
We did one on my perch cross, it was the only way we ever would have figured out what was going on. It's a great tool, if we hadn't found the problem he probably would have done a lot more damage and be much worse off long term. It ended up being more damage than what he was showing us pain wise, and we could tell it had been chronic.
For us here in Phoenix, I am aware of 3 options for MRI:
1. A "standing" low-field MRI that can be done under sedation
2. An "open" MRI, also low-field, that can handle larger body parts like heads, but that requires general anesthesia
3. A high-field MRI (the mobile MREquine unit) that requires general anesthesia
According to my vet, the high-field MRI gives a better quality image than the low-field. The cost for the MRI Mr. Blondie had done was $2500, which included the anesthesia, 3 days / 2 nights at the vet clinic, and - as far as I know - everything related to the MRI.
I brought him in on Tuesday afternoon. My farrier had pulled his shoes & trimmed his feet. Two vet interns then spent ~ 2 hours cleaning & x-raying & cleaning & x-raying & cleaning & x-raying his feet to remove every last bit of metal. They went through 9 sets of x-rays. They also inserted a catheter in his neck, and - ew- sewed it in place. That was kind of gross, but it didn't seem to bother him.
He was NPO after midnight. Wednesday morning, they induced him around 8:15ish. They did not let me watch the induction, but I did get to see him after he was intubated, and I watched them load him into the semi and get set up for the MRI. Then I watched a couple slices on the monitor and went home.
It was somewhat disconcerting to see him sacked out on the table, hooked up to the ventilator. The BIG ventilator. WHOOSHHHHHHH WHOOOOOOOOOSHHHHHHHHHH WHOOOOOOOOOOOOSHHHHHHH
I'm kind of glad they didn't let me watch him going under.
It took them ~ 2 hours to MRI both front feet. They called me when he was back up on his feet and back in his stall. That was around 11:40 am.
I went to the clinic that afternoon to check on him and give him his Isoxsuprine Newtons - he was a little subdued, but had eaten a little, was drinking, and was peeing & pooping.
I brought him home Thursday morning around 10ish. He was still a little subdued, but stuff that was supposed to be going in was going in, and stuff that was supposed to be coming out was coming out. Friday morning, he was a little disinterested in breakfast, but by noon he seemed to be back to his normal self.
The vet had warned me about the dangers of general anesthesia, but it's an excellent vet clinic, and Mr. Blondie is generally a pretty mellow guy (if the pony's not bugging him and if you're not trying to blanket him). I felt it was an acceptable risk.
And now we know what's been going on with his off-and-on lameness for at least the last year & a half, and possibly longer:
Primary MRI Findings:
Inflammation within the navicular bones bilateral front feet.
Flexor cortical defect with a small adhesion to the deep digital flexor tendon right front foot.
Desmitis of the distal straight sesamoidean ligament left front leg.
Not exactly the news I was hoping for, but at least we know, and we have a plan of action.
A year & a half ago, his x-rays were basically clean, and he responded to coffin joint injections and a couple courses of Vioxx. This time, x-rays showed a central flexor cortex cyst, so we opted for the MRI to see what else might be going on.
Would I do this for 20-year-old Prozac Pony? Probably not. But I'm glad I was able to do it for Mr. Blondie.
Approved helmet: Every time; every ride.
"When a sport gets to be predictable it ceases to be fun." - RAR's wise brother
Standing MRI (so not general anesthesia) done with diagnosis of collateral ligament damage (P3-P2 collateral ligament). Treated and horse returned to work, then things went bad four years later. Another MRI showed collateral ligaments not majorly re-injured, but accompanying scintigraphy showed problems elsewhere, including neck that may have been driving the front end issues.
Both MRIs were preceded by scintigraphy. Unfortunately we only did the front feet and not the whole horse the first time. I don't think my vet does the MRI without the scintigraphy first, at least for the particular issues with which we were dealing. (a barn mate who uses a different vet got the MRI done without the scintigraphy, also for a possible foot issue, and didn't get much out of it)
Both MRIs and the second scintigraphy gave me lots of useful information.
Agree, standing MRI is the way to go. Just too much risk involved in that recovery room.
But if you can afford it, I've seen several mystery lamenesses cleared up through the use of MRI. Ruptured DDf, fractured coffin bone that was invisible on radiographs, issues with the navicular. Granted, I was just a tech at the hospital and didn't follow the cases closely, but there were plenty of answers found for frustrated owners.
But as a tech, I can't reiterate strongly enough: avoid full anesthesia if at all possible.
Had one done last month at Texas A&M. it was done under general with no problem and diagnosed an injury to the right frton impar ligament. the cost of the MRI was considerably less than what everyone else is quoting and my insurance (which I'm sure will drop me in August) paid for most of it. We were able to come up with a clear treatment plan (stall rest) and timeline.
Thanks all! RAR that is great, great information, and thanks for the links to the photos and videos.
Talked to the vet this morning and she is sending everything we've done to the University so they can take a second look. They may think of something we haven't tried, or just come up with something else. They can do the MRI on July 10th, so that isn't too bad of a wait. Hopefully they can come up with something else to determine what's going on without having to do the MRI, but of course I'm not holding my breath.
It's so hot now that the ponies don't have much energy to do anything other than stand around and sweat. I can't ride until after work, and it's way too hot then, so I'm not missing much right now anyway.
Keep the stories coming guys!
Ultrasound was not giving a clear picture of what was going on in my mare leg and it was not healing on its own. Problem showed up clear as a bell on the MRI and we were able to make better treatment decisions. Mare eventually came completely back.
There were a couple of issues during the MRI (sorry, it was long enough ago that I don't remember the specifics) but they just meant she stayed an extra hour or so the day they did it.
I would definitely do it again if the circumstance called for it.
There is something about the outside of a horse that is good for the inside of a man.(Churchill)
One of my horses had an MRI for a distal front limb soft tissue injury (torn ligament) a few years ago; I wish I had done it sooner!
I had waited and tried other diagnostic tools and rehab before springing for it, and I wish I would have just sprung for it off the bat; it would've saved me money to have a solid diagnosis from the start.
I opted for the anesthetized MRI; stronger magnet (3T vs 1.5T in the standing MRI), better pictures. I didn't want to risk the possibility of movement artifact ruining any potential diagnosis, especially because we couldn't localize the injury to the hoof. The injury did end up being proximal to the hoof, in the pastern, so I'm very glad I went for the general anesthesia MRI. I also had mine done at a university that is well-known for their anesthesia team, so I knew he was in good hands.
I would do it again in a heartbeat, though I do hope I never have to do it again.
I did a stand up MRI on both front legs/feet of a horse with a history of intermitent but increasing lameness. We had xrayed and injected the coffin joints prior to the MRI but he didn't ever come completely sound. The MRI gave the diagnosis, not a great one, but without it we would not have known what we were dealing with. I think it was about $1,500 for both front feet.
tuppy - The MRI coming to the University is MREquine. It makes me a bit more comfortable knowing it is working well and actually hearing from someone who knows all about it. I admit, it's a bit scary, but unless the University can come up with another way to diagnose, it is the right thing to do for my boy. Thanks for your input and helping me to feel more comfortable about the whole thing!!
What I get from the above two articles, plus some experience with magnetic resonance in the chem lab, is that the standing MRIs are permanent magnets, whereas the recumbent ones are often superconducting. In order to get the higher field (more Tesla) at some point you have to go superconducting. Higher field gives you better resolution (clearer images and fewer scans to get the same image). But I could be wrong.