4 yr old w/djd in fetlock diagnosis - how would you treat?
Good morning! I am working with my vet, but thought I'd get some more experienced opinions and thoughts. I'm pretty long-winded online, sorry.
Long story short: 4 yr old Morgan, in dressage training, flexed bad front left and x-rays show narrowing on the inside of the fetlock and a small bone spur forming. Diagnosis of degenerative joint disease. Only symptom is slight head bobbing lameness tracking right at the trot and vet was able to see it while trotting straight while looking from behind.
Long story long: (skip ahead if you have enough from that bit)
My four year old Morgan turns in on the front, and has developed a slight limp will lunging at the trot, tracking right. We had suspected ringbone in his right front due to a lump he has near the fetlock, so I took him in for a lameness exam this weekend. Surprisingly, he flexed fine on the right front, but flexed horribly on the left front.
We x-rayed both. Left front because of the flex results; right front as a baseline and to see about the lump. Right front joint is solid and clean, the lump appears to be some calcification from a prior injury and is well away from the joint. Vet isn't remotely concerned about that.
Left front, however, is ugly. The turning in has caused some narrowing in the inside of his fetlock, and a small bone spur is developing. So I got the ugly "degenerative joint disease" diagnosis, and a "I'm so sorry" as my upper level dressage goals seemed to crash at my feet. Many, many options were put out there, and I'll be honest - it hit me hard, so I didn't really ask the questions needed and come away with a solution. We left the office, I picked up glucosamine, and spent the weekend researching. Rode him yesterday with boots, with no lameness issues and had a great ride.
So ... I'm a little more positive today, and have done a ton of research and am making future plans. While I will of course be working with my vets, I'd like to hear people's experiences and a "what would you do" type of scenarios.
I have re-evaluated our goals. In a way, it's helping me be more realistic about my time and finances, and whether I really had the drive and ability to bring him along as far as I wanted. Realistically, I would love to get him to showing third level. We'll see what his fetlock will tolerate - any experience with DJD in the fetlock and dressage?
What I do remember the vet saying:
1) Start him on glucosamine
2) He is a strong candidate for Legend treatment as a 4 year old
3) All the regular joint treatments are a possibility - she discussed injections, Adequan, etc - all of which she seemed open to but left up to me
4) Changing his trim on his front left so he lands as flat as possible to try and keep him from rolling in and pinching that spur; avoiding shoes that will restrict his hoof's natural ability to roll and decrease pain
5) My farrier has (pre x-ray) recommended a chiropractor to loosen up his neck and shoulders which are very stiff and he believes is contributing to his turn in. It's more pronounced when he's anxious and we are able to manipulate and loosen muscles near his shoulder that make him stand straight. The straighter he stands, the more we will slow the progression of the djd. Vet said she could neither recommend or discourage a chiropractor, as it's not "traditional medicine", but that "it can't hurt him, just your pocket book."
6) I'm sure she said a whole bunch of other things that I'm not remembering.
I do have a call in to the vet again now that I'm not staring at an x-ray and watching all our goals fall to the floor I also started a list of questions based on research
What would YOU do given this diagnosis? Note: at this point, selling is NOT an option. He has a home with me, and I will adjust my goals accordingly without feeling resentment. In fact, this diagnosis has brought a little relief of the pressure of bringing along a talented horse like this.
1. Would you even consider continuing dressage training, with lowered goals (give up upper level goals, and shoot for 2-3rd level?) Or just figure you have a really nice trail horse?
2. He is currently on full care with approximately 12 hours turnout/12 hours stall daily. This can vary 4 hours either way (more stall in winter, more turnout in summer). He could be moved to 24/7 pasture board. He does very well in a stall, likes a routine, and keeping him in a stall will ensure he gets his joint supplement every day and help us monitor his weight easier.
3. I'm considering starting him on Pentosan, after all my research this weekend. The goal would to be to keep him sound and extend the life of his joint. Seems like people who have done the Adequan/Legend treatments are really liking Pentosan. Thoughts? Too early since he really isn't struggling much? Do these types of things help if used in early arthritis?
4. Anything I'm missing, that you would do?
Thanks in advance to anyone who got through this long post and has advice.
If you don't like something, change it. If you can't change it, change your attitude.
~ Maya Angelou
I wouldn't panic yet! Even though your horse is young, every horse that works for a living will develop arthritis / DJD during his career at some point. I think you are smart to research your options and decide on a plan that suits you and your horse best. None of my horses are managed exactly the same since they are different ages, in different stages of their career and carry different workloads. I have been able to keep them all working happily and comfortable using different combinations of injections, Legend, Adequan, Pentosan and MSM, chiro, etc... The key has been a great working relationship with my vets, farrier, and being sensitive to changes in each horses behavior and willingness to invest in a good, flexible maintenance program.
I think you will find good options that will keep your horse working and performing in a way that you'll be happy with.
I would definitely go for adequan or pentosan.
I got a djd diagnosis on my 4yo in the right hock.
I tried Adequan and it seemed to help after the loading dose but it didn't last. Then I had steroid IA injections done and that lasted about 3 weeks.
Now I've got her on pentosan and I'm very happy with the results. She still has 'lame' days here and there, and needs a good warm up, but things are going well.
I have had to adjust my plans for her though mostly because of all the different treatments and rehabbing. I never had upper level plans, more just local shows maybe eventually working to 2nd/3rd level. But now I'm just seeing how things go, right now she's sound so I'm going to keep going until that changes.
At the worst I'll have a nice trail horse, no matter what she is with me for life.
She is on pretty much the same turnout schedule as your guy.
Also the best thing for arthritis is to keep them moving, my mare is worked (ridden or lunged) at least 6 days a week, usually 7.
I don't think this has to be the end.
Irap down the road and some possible joint injections now. I have done stem cell injections in one of mines knee for djd and a bone spur. It did actually make him much more comfortable and i had the bone spur removed with some shaving off of the arthritis as well at the same time. He was older though, really a lot older but it did make him comfortable for many years.
Horses aren't our whole life, but makes our life whole
Thanks everyone. I did finally talk to my vet. She classifies it as "very mild arthritis" at this point. When presented with my goal of slowing the progression, keeping him as sound as possible, and continuing his dressage training/career but with lowered goals and a "day by day" attitude, her responses were as follows:
1. Stall vs. Pasture: she can make an argument either way, and knowing the environment he is in thinks his current stall board and amount of turnout is probably right for him. She brought up that in pasture there are more flies, weather issues, etc., and being in the barn can give a break. So I will keep him on stall board ... which I felt was right for him for other reasons and would only have put him outside if it would make a large difference to his joints.
2. She prefers Adequan to Pentosan. She's had some barrel racers and such use Pentosan but says with Adequan being FDA approved and tested she's just much more comfortable with it.
3. She absolutely said if I'm going to continue in dressage training with him that he is a superb candidate for injections + Adequan therapy. She said sooner rather than later - wait a year, no; wait a month or so, fine.
So ... that sounds like the plan. Because he's young she's feels it's worth being proactive like this.
If you don't like something, change it. If you can't change it, change your attitude.
~ Maya Angelou
I'm basically in your exact situation- my horse was diagnosed with arthritis in the fetlock last fall (as a 3 year old) She's been evaluated by 3 different vets, all of who have given different prognosis (ranging from very optimistic to pretty despairing) I've been giving her Adequan monthly and she has been doing well, but started having some issues again as soon as the ground in the ring turned hard (not outright lame but seemed a little less forward and fluid). I'm moving her next month (hopefully) to a facility with better footing, I'm also starting her on Cosequin ASU next week- no idea if that will help but the small amount of scientific evidence, plus the anecdotal evidence, looks promising.
I know very little about Pentosan- neither of my vets have said anything about it to me but after the responses to this thread I am definitely going to look into it!
my 4 year old morgan has today been given the same diagnosis and we are probably going to do the surgery. what did you end up doing and did you find your course of action beneficial? we are looking at jointgaurd and pentosan also in the course of our guys treatment.