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Coffin bone stress fracture and collateral ligament injury

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  • #21
    PONY4ME- thanks for your updates. Wonderful to hear your boy is on the road to recovery !

    I have a question or two, as I'm going thru the same ordeal right now, except I won't get an ultrasound til Monday, so we have no diagnosis....
    2 weeks ago my guy came up dead lame left front, looked like a typical abscess presentation all though there was swelling, heat, tenderness in the fetlock & pastern.
    As luck would have it my Farrier was at the farm, pulled the shoe, hoof tested, scraped some excess sole , and was NOT convinced of an abscess. Called the Vet who strongly felt it was an abscess, and to let it ride over the weekend.(Stall rest, poultice, cold hosing tendon/Ligament ,wrapping, 1 gr Bute for 2 days only)

    Long story short, I treated for both abscess and T/L injury over that weekend, insisted Vet come Monday.
    Swelling and heat were completely gone after the 3rd session of cold hosing.
    Horse was blocked, high and low. High block gave 90% soundness. Followed with xrays, which only showed calcification of MCL, but nothing too exciting otherwise.
    Continued stall rest, and Animalintex poultice for hoof, and standing wraps up front. We are now at 2 weeks with zero improvement. Farrier has been back out to look further, still non reactive to hoof testers, and no sign of abscess.(continue to poultice & wrap)

    Horse has been weight bearing since the 2cnd day, but gimpy when turning(walk), head bobbing at the trot. Still 3+ out of 5 at trot( only asking for a few steps each week)....

    So my question to you, did your horse present with any of these symptoms ?

    Sorry to ramble, just frustrated by still not having a diagnosis, and therefore no idea of rehab and prognosis. Trying to educate myself about MCL injuries just in case this happens to be one. He does have longer pasterns, with a tendency for low heels, and wider flattish feet than ideal.

    Thanks for listening, and continued recovery !

    Comment


    • #22
      Snoball, if your horse has a coffin bone fracture, the fracture might not show on rads until several wks post break. Been there, done that. Mine also was not reactive to hoof testers and 2 diff. practices thought an abscess. Good luck!

      Comment

      • Original Poster

        #23
        Hi, Snoball,

        Unfortunately, I may have to welcome you to my world. My horses's condition presented via the dreaded Mystery Lameness back in September. We gave him lots of time off, did rads which showed nothing, hoped for an abscess, changed the shoes, and gave him more time off. Some days he was ok for a light ride, but usually not. He'd be ok on the long side of the ring, but a slight head bob at the trot going around corners to the right. We kept his usual all-night turnout. Finally in November I contacted an animal communicator who was highly recommended by a friend. I was skeptical, but a $50 AC session was nothing compared to what I'd already spent for rads, lameness workups, blocks, special shoes, etc.

        AC asked the horse where it hurt and got his "answer" which was in the form of an image of a thin red line going through his hoof deep inside. At this point, I was ready for the vet to ultrasound, but I decided to skip the ultrasound and do an MRI which revealed stress fracture and collateral ligament of the coffin bone injury. My vet confirmed that this would not have been visible on an ultrasound, due to being deep enough inside the foot. My very capable trainer looked at the rads too, and didn't see anything. I felt a bit funny using an AC for anything other than entertainment, but both the vet and my trainer have had instances where the info was helpful, so they didn't think I was a total fruitcake.

        Anyhow, once they had a diagnosis, they could devise a treatment plan, and that's where we are today. In retrospect, I should have done the MRI sooner, but a $3000 MRI is usually not the first thing done for Mystery Lameness. But by the time I decided to do the MRI, I had spent about $2000 trying to figure out what was going on. And we never go to stall rest unless we have a good reason to do so. My barn has lots of good turnout, and we let the horses be horses whenever possible. So it was rock and hard place from the very beginning.

        Hope you find out what's going on with your horse, and I'm glad that someone finds this thread useful.
        It's 2017. Do you know where your old horse is?

        www.streamhorsetv.com -- website with horse show livestream listings and links.

        Comment


        • #24
          Thanks so much for your info ladies.

          GNU- yes, we haven't ruled out a fracture yet, but based on the way this is behaving both of my Vets, plus my Farrier are all leaning heavily towards MCL of the CJ...

          Evidently my Vet who took the xrays has done extensive training in radiology technique , and feels pretty confident she'll be able to get a good look via Ultrasound with out needing MRI, but neither Vets have ruled MRI out either.
          They both feel if it is the Collateral Ligament she should be able to see that on Ultrasound, obviously if that does not bear out, then MRI is the next step.
          I''ll have a fairly long haul(2 hours+) to get to an MRI, so we'd rather not have to go that route if at all possible.

          So my next question is did either of you consider Stem Cell,PRP, IRAP & shockwave ?? I'm reading some people feel it was very helpful, some not, some didn't do anything but rest.
          PONY4ME- I agree I hate keeping him locked in his stall, but since I wasn't convinced it was an abscess, I didn't dare turn him out, or even hand walk him. I felt so terrible, but knew rest wouldn't hurt an abscess, but turn out would make a Tendon/Ligament injury worse. My guy was far too lame to turn out the first weekend, and when the Vet got there on Monday she forbade even hand walking...
          However, stall rest doesn't appear to be helping yet

          Let's keep this thread going for each other and any one else looking for info on diagnostics, treatments and timelines.

          Comment

          • Original Poster

            #25
            We did PRP and three shockwave treatments.

            If he's ok, then I'll say they worked. If he's not ok, I'll assume it was a waste of money.

            You don't know until it's over. My plan is/was to do everything that was recommended and that way I won't be wishing for a time machine to go back and do something I decided to skip.
            It's 2017. Do you know where your old horse is?

            www.streamhorsetv.com -- website with horse show livestream listings and links.

            Comment


            • #26
              We are now four months post injury with our boy (3 year old Han stallion). When it first happened it also presented as an abscess so we stall rested ect for a week. After a few days I figured there is no way it is an abscess so the vet came and xrayed about a week later and we could easily see the fracture going through the wing of the coffin bone and just touching the joint.

              Stall rest was ordered, a small bar shoe was put on and we were told we had a decent chance of him coming sound. After two months of stall rest he was sound at walk but NOT when turning. The vet xrayed and we found the collateral ligament had avulsed...as in about half of it tore off from the bone of the P2. Obviously we were really heartbroken and vet said maybe 50 percent chance he will come sound. If he is not sound in another month then basically we were to give up hope of him eventually coming performance sound.

              So we decided to do four rounds of IRAP into the joint and then re xray. After the second round he came totally sound while turning around. We just re xrayed and he the joint is crystal clear, fracture is almost completely filled in and the part where the bone avulsed is showing major healing. Vet said it is even better than what he thought was best case scenario..ie he is thrilled. We are going to now do PRP on the collateral ligament and now we start the handwalking (lots of fun with a young stallion! lol ).

              Anyways, I (and the vet) feel the IRAP made a huge impact on how well he has healed this far. I felt really bad keeping him in like this but he was adjusted so well and remains bright and happy. Will update in a few months.
              www.svhanoverians.com

              "Simple: Breeding,Training, Riding". Wolfram Wittig.

              Comment


              • #27
                Hi Snobal

                I had a horse present with the exact ssame symptoms as your horse.
                Came in from turnout 3 legged. Treated it as an abscess through the weekend. Called the vet who blocked him. X-rays showed nothing. He blocked out at coffin joint level. So we injected the coffin joints. And started stall rest. Horse did not come sound. Changed shoes and angles. Horse would get a little better ie. a 2 or 3 out of 5 lameness.
                I drove 3 hours for a second opinion and an MRI.
                Ended up as a Medical collateral ligament rupture off of the coffin bone with some bone involvement.
                The vet at the big clinic said that we would not have been able to see the tear without an MRI. It is too deep within the hoof to see reliably.
                I did not have the money to do IRAP and at that time PRP was not mentioned.
                I took my horse home and did 7 months of stall rest. I was allowed to do hand walking. Starting at 5 minutes and building up to 30.
                I did 7 months because my horse was essentially snowed in for the winter anyway and I might as well give it sometime. Horse was sound at the recheck and I was able to start under saddle work. I added time to whatever # the vet gave me and was cantering a year after the initial injury.
                Horse is sound to this day, but retired because he is 25 this year. He is sound. But a bit creaky. He was 22 when the injury occurred and did recover do do some light jumping.
                "Half the failures in life result from pulling in one's horse when it is leaping."

                http://www.facebook.com/album.php?ai...7&l=eca0d15457

                Comment

                • Original Poster

                  #28
                  Wednesday's vet recheck has been delayed due to horse having some type of allergic reaction to something Saturday night, and now being on all kinds of meds. If we did a lameness recheck right now, he'd probably be able to W/T/C/Jump and do a Hunter Derby.

                  He gave us quite a scare Saturday night. It all started with coughing and very labored breathing, and vet could only hear one lung functioning. He did an ultrasound which confirmed only one lung working properly. So they treated for pneumonia, severe allergic reaction, drew some blood for a workup and did a DMSO IV. Nothing in his environment had changed so we are all baffled.

                  He was fine 24 hours post initial event, and today looks totally normal. He's still getting antibiotics, banamine, dex and some cough syrup. He will have to be off the drugs for a few days so the vet can properly assess his lameness. So today is day 120 of stall rest, with maybe another week to go before we know anything. He's up to about two or three hours of round pen turnout per day, with very little ace and has been behaving.
                  It's 2017. Do you know where your old horse is?

                  www.streamhorsetv.com -- website with horse show livestream listings and links.

                  Comment


                  • #29
                    PONY4ME - soooo sorry to hear your boy had a set back, wishing a very speedy return to normal!

                    On my way now to my horses US, didn't happen yesterday as planned, what's one more day...should have an answer in a couple of hours.

                    BLUEHORSE: thanks for your updates too !

                    Comment


                    • #30
                      US found tear of MCL with small chip, but Vet doesn't think that's the whole story, so now heading Monday for MRI & Contrast CT scan...
                      Obviously Wing fracture is a distinct possibility, as well as further soft tissue damage inside the hoof.

                      Friday will be the 3rd week of stall rest, showing no improvement, possibly worsening when turning, looking very gimpy moving in the stall...

                      Very, very concerned this may be the end of a career....being positive pasture sound, or possibly low level wtc would be awesome !

                      With your experiences with MCL tears, were your horses this lame, and for how long ?

                      Comment

                      • Original Poster

                        #31
                        Vet checkup yesterday (follow up from Saturday night's emergency) revealed healhy horse and normal bloodwork. Good news there.

                        Vet said to discontinue all feel-good meds, and we rescheduled the postponed lameness recheck for this coming Monday which will be day 124 of stall rest. Good news there.

                        The horse has been going outside in a small grass pen for longer times and with lower doses of ace. Yesterday he was drug-free and out for about four hours happily grazing. Good news there.

                        Today he went out, and absolutely EXPLODED! Roll, buck, all four feet off the ground. The barn staff ran out to stop him, gave him a shot of ace and turned him back out after his drugs kicked in. So that's the bad news. I'm not usually one to see the glass half empty, or the horse probably lame, but I fully expect him to be unsound for Monday's checkup.
                        It's 2017. Do you know where your old horse is?

                        www.streamhorsetv.com -- website with horse show livestream listings and links.

                        Comment


                        • #32
                          PONY4ME !!! I'm sooo sorry to hear your boy may have given himself a set back. This is very disheartening to hear, but for what it's worth I'm sending strong positive vibes for you both, that he only stung himself, and will be solid by the Vet recheck.

                          The whole stall rest rehab protocol just bums me out to no end, because of these explosive episodes where they can re injure them selves, along with the muscle wasting, and general loss of fitness.... I suppose there's no better alternative...

                          Comment

                          • Original Poster

                            #33
                            Vet recheck today, After 124 days of stall rest and eleven Uncle Jimmy's Hanging Balls, he trotted sound! Rehab plan is 30 days of walk/trot. Straight lines only for trot work. No corners or circles at the trot until at least next month. Turnout stay the same. Round pen only for maybe three hours a day. Ace if needed to minimize explosions. I'm going to try to get them to move the round pen again so it's over some fresh grass. Sunday I scattered a bag of mini carrots throughout the round pen and let the horse hunt for them. He enjoyed that.

                            Feeling somewhat relieved, but still very far from the end of the process. Vet commented that we were really about seven months post injury, so his recovery is progressing normally. Total rehab should still take a full year.
                            It's 2017. Do you know where your old horse is?

                            www.streamhorsetv.com -- website with horse show livestream listings and links.

                            Comment

                            • Original Poster

                              #34
                              We are now 18 days into walk/trot rehab. The first five days were walk only. After that we added some trot work, and horse is now trotting down the long side of the ring six times during a twenty minute rehab ride. I got to do the rehab ride today, and he is trotting soundly. He usually spends a couple of hours outside in the round pen where he can graze, and then we can do his rehab ride without any ace. Vet is happy with his progress.
                              It's 2017. Do you know where your old horse is?

                              www.streamhorsetv.com -- website with horse show livestream listings and links.

                              Comment


                              • #35
                                Congratulations on the recovery progress you have made.. You must be feeling somewhat better than you did when you started this thread. I wish you continued progress with your boy.

                                Comment


                                • #36
                                  navicular fracture

                                  Hi,

                                  I am reading with interest the posts on navicular fracture as my 16.2hh has just done this in the field on impact on a stone. Following x-rays the vet has recommended long term turnout without shoes which seems to go against all the advice given here. Has anyone tried this with any success? I am also considering a combination of comphrey and calc phos to aid healing. Any help welcome.

                                  Thank you.

                                  Comment

                                  • Original Poster

                                    #37
                                    Update after about 70 days of slow back to work. We are up to 30 trot lines during a rehab ride. Still no corners, still no circles. Plenty of walking too, and some walking around the farm. No drugs needed, and horse is being pretty cooperative except for the occasional random excited moment. Horse got pentosan injection today, and I think gets another in two weeks. Turnout is still 2 - 3 hours a day in the round pen, with plenty of hay to keep him occupied. He's calm enough that I've been able to hand graze him too. Plan is to keep the current routine at least until the middle of August and then recheck.

                                    Trainer rides him three times a week. I ride him three. Horse feels and looks sound both directions. Vet watched him go today and agrees.

                                    And I've lost count of how many Uncle Jimmy's balls we've been through. Once he figured out how to bite them off the rope, get the whole thing on the gound and make it a single-serving treat, it was hopeless.
                                    It's 2017. Do you know where your old horse is?

                                    www.streamhorsetv.com -- website with horse show livestream listings and links.

                                    Comment

                                    • Original Poster

                                      #38
                                      Haven't updated in a while, but we've made significant progress since the last time I posted. In late August we were allowed to trot all the way around the ring on his "good" side. The vet watched him trot a corner on his "bad" side, and said to wait another month or two. On November 2, he walked and trotted sound both directions for the vet. After seeing that the walk and trot were ok both way, the vet asked to see him canter, and he was sound both directions! Vet ok'd him for trotting completely around the ring both directions, but asked us to coordinate getting an "after" xray, and resetting his shoes before adding canter work and resuming normal turnout. The plan is to add canter work very slowly and make sure he stays sound. With me being a nervous mom and him being a TB, he will probably have Ace as a turnout buddy for a few days.
                                      It's 2017. Do you know where your old horse is?

                                      www.streamhorsetv.com -- website with horse show livestream listings and links.

                                      Comment


                                      • #39
                                        Good to hear!

                                        I also have super good news...our three year old stallion has been totally sound since he came off six months of stall rest a few months ago (broken coffin bone, almost completely torn collateral ligament). He has been started under saddle and is progressing well. I am pretty surprised to be honest...knock on wood he holds up!!
                                        www.svhanoverians.com

                                        "Simple: Breeding,Training, Riding". Wolfram Wittig.

                                        Comment

                                        • Original Poster

                                          #40
                                          Hopefully this is a final update. About fifteen months post injuries, horse is back on normal turnout and is sound both directions, at all three gaits. Still no jumping, but that will probably come later. I'm very grateful to the vets, farrier, barn staff and trainers who went above and beyond keeping him quiet and happy, and gradually easing him back into work. We were lucky the horse was sensible and cooperative most of the time, as one big stupid explosion could have started us back at the beginning. Looking forward to a better 2013. Fewer vet bills, and more saddle time!
                                          It's 2017. Do you know where your old horse is?

                                          www.streamhorsetv.com -- website with horse show livestream listings and links.

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