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Hard to Diagnose-Your Thoughts?

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  • Hard to Diagnose-Your Thoughts?

    I would appreciate any thoughts you may have on this scenario - sorry it's a bit long.
    Last summer, horse lame on left front. No heat or swelling, blocked almost sound third time up the leg. X-rays and 2 ultrasounds showed nothing wrong with any tendons. Vet was puzzled as she couldn't see anything wrong anywhere. Laid up for roughly 2.5 months, limited turnout, icing. Brought slowly back to work. Was GREAT until a few weeks ago. No events we know of to trigger it. Showed slightly lame, but not anything like before.
    Vet came out - sound on longe, passed flexion tests (all legs) with flying colors. No heat or swelling anywhere. Got on and rode, fine at first, then ouchy.
    Injected head of suspensory (left front) with steroids (suspected some swelling somewhere) a week off with icing and limited turnout. Tried again and now it's more like a 'hitch' in his gittalong, actually looking like it's higher - much better, but not 100%.
    Walking 15-20 min daily this week, will check again the first of next week. I'm stumped as all diagnostics can't seem to find anything. Vet is very good at diagnosing lameness - was at the local University for years. Anybody else dealt with something like this? TIA!!!
    Some days the best thing about my job is that the chair spins.

  • #2
    I would aggressively pursue an actual diagnosis now, before this becomes an injury that does not heal properly.

    Time for bigger diagnostic guns (and this is no reflection on your vet -- it's a "tool" issue!); perhaps a bone scan or an MRI.

    Until you figure out exactly where and what you can't really develop a good plan for rehabbing it and you won't know how to assess whether it is genuinely healed enough to increase his work. You'll just be stuck in a blind cycle of resting, returning to work until or unless he breaks.
    The big man -- my lost prince

    The little brother, now my main man

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    • #3
      Originally posted by WB Mom View Post
      Last summer, horse lame on left front. No heat or swelling, blocked almost sound third time up the leg. X-rays and 2 ultrasounds showed nothing wrong with any tendons.
      More info please. Which blocks showed no improvement and which block showed the improvement?

      Ultrasound is notoriously bad at dealing with soft tissue near and in the hoof. I would probably have done an MRI last year to rule out something like a collateral ligament tear.

      Has the vet looked at the horse's back and SI? Its not uncommon for the horse to cause problems there if they are moving differently to compensate for an injury somewhere else over a period of time.

      Comment


      • #4
        How exactly is the horse moving when lame? Is it a head bob, is it a "hopping" type step? Is it at all 3 gaits?

        Comment

        • Original Poster

          #5
          Thanks everyone!
          Last year the vet did 3 blocks, one for his hoof, one at the fetlock and one below the knee. No improvement until the last (highest) one.
          I have a chiro come regularly for him and during his last adjustment (just prior to this episode) she commented that he was better than she's ever seen him. Not sure if she would see anything with back/SI? He head bobs at the trot, that's about it.
          What I consider strange is just a couple of weeks prior, he competed in his first event ever at Training level. That certainly was intense work for him, and he had no problems at all.
          What/how does an MRI or bone scan work vs. an ultrasound? Sorry I don't know a lot about all this stuff!!
          Some days the best thing about my job is that the chair spins.

          Comment


          • #6
            Sounds like it may be a high suspensory ligament issue

            Comment


            • #7
              Could be high or diagnol...right hind? And Lymes Disease? Something systemic? Withers or Neck?
              Just some quick thoughts....

              Good Luck!
              Until one has loved an animal, a part of one's soul remains unawakend. ~Anatole France~
              www.EquineKneadsLLC.com

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              • #8
                In a case like this I would find a good chiropractor to work on the horse. I've had work-ups done on lame horses by BNV clinics that have run into the [many] thousands of dollars only to have the issue end up being foot or body related and end up being addressed by $100-$200 in shoeing or body work.

                Most recently my mare was head bobbing lame on her RF when it was on the outside. We blocked her with no improvement and with one hour-long session of chiropractic and acupuncture she walked off completely sound and has been great ever since. Turns out she had "kinked" (for lack of a better word) something in her shoulder, and once we addressed it she was great.
                __________________________________
                Flying F Sport Horses
                Horses in the NW

                Comment

                • Original Poster

                  #9
                  Thanks for the additional suggestions!
                  I will check him tomorrow to see how he is and go from there. It probably is a good idea to have the chiro out again. My trainer keeps saying how stiff he is anyway. I'm all for treating as 'naturally' as possible first. My chiro also does acupuncture, so maybe a good full workup would help, or at least rule some things out before we would need to go to the 'big guns'. For sure it won't hurt anything to try, and if I'm really lucky it may help narrow down what we are dealing with.
                  Keeping my digits crossed!!!
                  Some days the best thing about my job is that the chair spins.

                  Comment


                  • #10
                    And just to throw this in - even though this seems like the 'same' thing - dont overlook that he could be lame on the same leg for a different reason. If he competed at his first eventing training event - then he was obviously pretty darn fit and sound before you competed him and that type of competition is tough on a horse - so he may have strained something in the same leg and it not be connected to the lame last time.

                    OR it could have been a ligament or suspensory strain that was healed and all and then after that kind of competition - strained it again.

                    Comment


                    • #11
                      Check ligament injuries can also be notoriously hard to detect and slow to heal, with periods of improvement that don't last.
                      Click here before you buy.

                      Comment


                      • #12
                        I would block and then if if fetlock, pastern foot region consider an MRI. If you haven't done radiographs in a year it could have been arthritis starting that has now again that is now bothering him. I think I would start from scratch exam, evaluation on hard and soft ground, new nerve blocks from the coffin joint working up until lameness resolves. Then radiograph, if clean consider MRI. If your horse does not block out of the lameness then it could be higher up or multiple issues and then consider a bone scan.

                        Comment


                        • #13
                          Sounds sort of like what my big WB had...minor tear in his right DDFT. Had one of the best lameness vets in CA look at him and he wasn't able to diagnose. Nothing showed up until I got an MRI. 9 months of stall rest he came out sound for 5. Then was off for another 9. He's been sound for 3 years. Go figure.

                          We would have just considered him navicular had we not gotten that MRI. If you have insurance, they should pay for the MRI and any treatments that come after. However, this leg will probably NEVER be insurable.

                          Comment

                          • Original Poster

                            #14
                            As far as the time between the event and this episode, it was over a month, so it's hard for me to think it was caused by this.
                            However, you're absolutely right, it is entirely possible he is lame for a different reason. I checked him on a couple of days ago, and he looked really good going straight, and shortened up just a bit going around the corners. He actually felt really good. He seems to be coming back much much faster. We are doing unlimited walking this week and I will check him again the first of next week.
                            I think I will probably end up having an MRI done on the leg just as soon as I can get the $ together. Hopefully that may help see what's going on in there. As long as he keeps getting better, I don't feel too bad that I can't do the MRI right now.
                            In the back of my head I keep thinking he just stepped wrong and tweaked himself. Probably will never know if that is what really happened. However, I do know it does happen - not only to horses, but I've done it to myself as well!
                            Thanks again for all the GREAT advice! COTH rocks!
                            Some days the best thing about my job is that the chair spins.

                            Comment


                            • #15
                              Originally posted by WB Mom View Post
                              Thanks everyone!
                              Last year the vet did 3 blocks, one for his hoof, one at the fetlock and one below the knee. No improvement until the last (highest) one.
                              I have a chiro come regularly for him and during his last adjustment (just prior to this episode) she commented that he was better than she's ever seen him. Not sure if she would see anything with back/SI? He head bobs at the trot, that's about it.
                              What I consider strange is just a couple of weeks prior, he competed in his first event ever at Training level. That certainly was intense work for him, and he had no problems at all.
                              What/how does an MRI or bone scan work vs. an ultrasound? Sorry I don't know a lot about all this stuff!!
                              the 2nd lameness was also the left front?

                              time to put that sucker in an MRI.

                              and for future issues: insurance rocks in times like these. Turns 2K into $350 (+ your annual fee). So it will knock 50% of your normal non insurance bill.
                              http://kaboomeventing.com/
                              http://kaboomeventing.blogspot.com/
                              Horses are amazing athletes and make no mistake -- they are the stars of the show!

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                              • Original Poster

                                #16
                                Unfortunately, the insurance company has already sent me 'the letter'...
                                Some days the best thing about my job is that the chair spins.

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