Sport Horse Spotlight

Feinrich-Nr_1-12-18-10-074 Beelitz

Real Estate Spotlight

97 Spring Lane (1)

Sale Spotlight

  • Welcome to the Chronicle Forums.
    Please complete your profile. The forums and the rest of www.chronofhorse.com has single sign-in, so your log in information for one will automatically work for the other. Disclaimer: The opinions expressed here are the views of the individual and do not necessarily reflect the views and opinions of The Chronicle of the Horse.

Announcement

Collapse
No announcement yet.

nuclear scintigraphy - UPDATE

Collapse
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • nuclear scintigraphy - UPDATE

    Has anyone done this for lameness purposes on their horse? My vet is stumped on my ottb that has a clubby foot on the lame quadrant. X-ray hoof and it looks really good. Hoof tested negative. Stabby when trotting on that leg. He is a sensitive guy and is sensitive to sedation, so we are reserving an MRI as a last resort.

    Vet recommended nuclear scintigraphy to light up any inflammation in soft tissue and bone. I guess I am lucky because this is our first real lameness in the 6 years i've owned him. Bummed because this was supposed to be my last real hurrah showing before senior year of UG and *hopefully* vet school.

  • #2
    I haven't done scintigraphy, but I took my mare for an MRI when we couldn't diagnose her lameness. I would recommend an MRI, because the scintigraphy will locate an area, but you could likely need to do an MRI of that area afterwards to see the damage, tears, inflammation, etc. It's too bad your horse is sensitive, has he ever had anesthesia before? My horse went to New England Equine Medical & Surgical Center, and it was a GREAT experience. Thankfully, my horse is insured, and just about everything was covered!

    Comment


    • #3
      If you do a search for "bone scan" on here, you'll find several threads about it (short name for nuclear scintigraphy). I've had...5 (for 4 horses over the span of 10 years)!

      First one, it told us where to look further for his mystery hind end lameness, and further diagnostics revealed stifle OCD, which was successfully treated with surgery.

      Another horse had on again, off again lameness issues in a front lower leg. He'd also had prior high suspensory injuries in that leg, successfully treated and rehabbed, and past issues in the hoof that weren't fully understood as x-rays and ultrasound never revealed much. He was a horse that I did not think would do well with gen'l anesthesia so opted to try bone scan before MRI. Bone scan told us some things, but not enough, so did have to go on to MRI, which gave us true picture of what was going on and allowed us to treat the specific injury (medial collateral ligament in the foot). But he did have a hard time with the anesthesia...I won't do that to him again. Standing MRI was not an option close by at that time, but now it is.

      Next bone scan was for another hind end mystery. Helped somewhat to rule out some things, gave us a few things to look more closely at, but didn't really tell us much on him. That horse remains a mystery. When you try to make an appt at the lameness clinic and they call you back to schedule it for when every vet at the place can attend because it is "such an interesting case," that is NOT a good thing!

      Latest was a horse that had more hind end weirdness, mostly under saddle. Long story short...first bone scan gave us some clues, treated what we saw, continued to go badly. Year later, tried another bone scan to see if anything new would show up. Nothing. Along side this, lots of other diagnostics, including x-rays, ultrasounds, treatments (inject this, does it help? Give this drug, any response?)... If ever a full body MRI was available, he'd be the perfect candidate.

      You know your horse, so if you genuinely feel anesthesia is wrong for him, don't do it (I regret doing so with my one guy). Would standing MRI be an option? If you are sure it is lower leg, I'd opt for the MRI before bone scan if you can find a standing unit. I know people say standing isn't as good as the lay-down, but in your case, you are looking at bone scan vs. standing MRI and I'd choose the latter with what you've described.

      Comment


      • #4
        I don't know any clinic that is going to park your horse in front of their $$$$ equipment without sedation! That being said, does the lameness block to the foot? Considering that nothing shows up on radiographs I'd definitely opt for a standing MRI over a bone scan.
        Originally posted by EquineImagined
        My subconscious is a wretched insufferable beotch.

        Comment


        • #5
          Stabby when trotting on that leg.
          I would be looking at the trim/shoeing first.

          Three things specifically come to mind with a club foot:

          1) If the break-over point of the club foot is farther forward relative to the BONE inside than on the other foot, it can be a common cause of stabbing the club foot. Sometimes farriers leave the toe of the club foot flared, or simply too long to try to match the other foot and it creates excess leverage in the toe if the club foot. Do not try to make the two feet match,

          2)If the heels of the club foot are being lowered repeatedly to try to match the toe angle of the other foot, it can cause the club foot to be "stabby"

          3) most club feet land naturally on the lateral side.(slight toe first usually) It has to do with an asymmetrical long pastern bone. (P1) So If the farrier is unbalancing the club foot to attempt to force it to travel and land level it can directly cause coffin joint and/or collateral ligament lameness. A momentary uneven landing part of the stride is a lot less harmful than the uneven joint loading of an unlevel foot during the stance phase of the stride.

          Just some suggestions to look at . And trimming / shoeing is a lot cheaper than N.S. or MRI.
          Patty Stiller CNBBT,CNBF,CLS, CE
          Natural Balance Certified Lameness Specialist ,instructor.
          www.hoofcareonline.com

          Comment


          • #6
            X-ray hoof and it looks really good.
            can you post the Xray (just for a farrier's view of hoof balance, not a diagnosis) ?
            Patty Stiller CNBBT,CNBF,CLS, CE
            Natural Balance Certified Lameness Specialist ,instructor.
            www.hoofcareonline.com

            Comment

            • Original Poster

              #7
              I don't have the rads. Farrier and vet worked on him. He has some side bone development which she said was normal in cases of clubby hooves. His angles looked great. We just took off extra hoof as farrier was unsure about how much he could take off without rads being done.

              His RH (normal hoof) is actually the funky looking one on rads. His pedal bone was almost flat (unlike his normal angle on odd hoof) so it went in a 3 degree wedge.

              When his clubbed hoof used to need to get shod (along with the rest of him) he was more lopsided. I noticed him being slightly off in April. Thought he needed a trim. Anyways since then and even having vet out...can't figure out what is bothering him. At one point it almost looked like he had some bursitis going on in his shoulder. We lasered it but I didn't notice a difference.

              I have no problems sedating him, however he has to have a very small dose. A normal 1200 lb dose will drop him like a hot potato. The clinic that we are planning on taking him has a MRI service who comes, so we could have that done if the scan doesn't come up with anything.

              Our vet was not comfortable blocking him. He is insured. He is just a sensitive guy.

              Comment

              • Original Poster

                #8
                Before shoeing in may:
                http://i65.photobucket.com/albums/h2...0/937f9ba1.jpg

                After:
                http://i65.photobucket.com/albums/h2...0/555e8d32.jpg

                Just wanted to show the difference at the fetlock and knee. You can imagine his his shoulder was...

                Comment


                • #9
                  Originally posted by reay6790 View Post
                  ...Our vet was not comfortable blocking him. He is insured. He is just a sensitive guy.

                  Not comfortable blocking him from the foot up yet spends your money lasering a shoulder (whatever that refers to)?????

                  Thats nuts. How about a second opinion from a vet who is comfortable blocking him to locate exactly where the pain is coming from? They, the clinic, will block for either bone scan or MRI unless you want the whole leg done or risk wasting money shooting where you THINK it is and risk missing what is wrong completely.
                  When opportunity knocks it's wearing overalls and looks like work.

                  The horse world. Two people. Three opinions.

                  Comment

                  • Original Poster

                    #10
                    He got lasered by a different vet at the last horse show I took him to when he went lame. We scratched and he got lasered every day.

                    I do not know why she doesn't want to do him. As I said we can get him blocked at the clinic with the bone scan and MRI. They do full lameness exams. She wants a second opinion and thinks they are our best bet. I have a truck and trailer so hauling him isn't a problem.

                    Comment


                    • #11
                      If he is lame enough to block, yes, that seems to be the next step. Have the lameness clinic do a full workup and then that may steer you toward bone scan, MRI, or other options.

                      My most recent mystery horse wasn't blockable -- he didn't present as lame enough to block and would work out of it randomly. We actually did try it (blocking stifle where we did have a small irregularity on x-ray), but it was never conclusive about anything. So I wasn't sure if that is what your vet meant in not wanting to do the blocks - that she wasn't sure she'd seen enough of him lame to know he got better with a block. No matter what, sounds like heading to the lameness clinic is a good idea!

                      Comment


                      • #12
                        i work at a large equine clinic here in ocala. i am doing a bone scan on one of my guys tomorrow morning.
                        www.camaloufarms.com

                        ride it like you stole it! "ralph hill"

                        Comment


                        • #13
                          Originally posted by reay6790 View Post
                          Before shoeing in may:
                          http://i65.photobucket.com/albums/h2...0/937f9ba1.jpg

                          After:
                          http://i65.photobucket.com/albums/h2...0/555e8d32.jpg

                          Just wanted to show the difference at the fetlock and knee. You can imagine his his shoulder was...
                          I don't know if anyone else thinks those feet are really long and possibly contracted??

                          And horsepoor - I see the reason for your screen name.....

                          I had one of my horses scanned and it worked out great. Vets thought he had a right stiffle injury and wanted to do exploratory surgery in the stiffle - ahhh no - so my regular vet did the sintigraphy and it was a right side sacro injury. I had a full body scan and his left hock lit up too which in xray was a spavin. Treated both and for 4 years he was able to be ridden quite comfortably.
                          If you like the distance you see; continue forward. If you don't; stay still and the shorter distance works out. ~GM~

                          Comment


                          • #14
                            I've had 2 horses that had nuclear scans done, 5 years ago. Soft tissue issues often will not show up unless there is raging inflammation. I'd find a vet who will do blocks.

                            Comment


                            • #15
                              I have a mare who had a "phantom" on again, off again mild lameness. Tried everything including blocking the area. Finally I opted to have a bone scan done, adn I wish I had done so much sooner. The bone scan idnetified EXCATLY where the problem was located (OCD fetlock joint).

                              I would recommend that you considre having a bone scan performed on your horse. In the long run it may save you money and time trying to diagnosis the source of your horse's lameness.

                              Comment

                              • Original Poster

                                #16
                                Originally posted by doublesstable View Post
                                I don't know if anyone else thinks those feet are really long and possibly contracted??

                                And horsepoor - I see the reason for your screen name.....

                                I had one of my horses scanned and it worked out great. Vets thought he had a right stiffle injury and wanted to do exploratory surgery in the stiffle - ahhh no - so my regular vet did the sintigraphy and it was a right side sacro injury. I had a full body scan and his left hock lit up too which in xray was a spavin. Treated both and for 4 years he was able to be ridden quite comfortably.
                                Well his white foot is contracted as it is clubby...I don't think his RF is though...easier to see the shape in the after photo.

                                Nice to know that it may work we will go and see what the lameness team there thinks would help him the most in order to get a diagnosis.

                                Comment


                                • #17
                                  Yes. Twice. On the same horse, three years apart.

                                  First time we had RF lameness that blocked to the heel. Scintigraphy pinpointed the area in which to look and standing MRI showed collateral ligament strain. Treated, rehabbed, back to work, including jumping.

                                  Second time had RF lameness and stabby movement (as described by the OP). Heel block partially resolved. This time I had the whole horse scanned and, in addition to a mild re-injury of the collateral ligaments, discovered neck arthritis. Vet thinks that both rounds of the collateral ligament damage may be associated with the neck issues. Both vets (the one that did the MRI and my regular vet) said the feet were fine.
                                  The Evil Chem Prof

                                  Comment

                                  • Original Poster

                                    #18
                                    We were referred to a specialty clinic who has a bone scan. He got done on Wednesday. Here is what lit up:
                                    -LF: elbow, knee
                                    -RF: fetlock
                                    -both hocks

                                    We started him on Tildren. We asked about a possible soft tissue injury, but the vet said we had enough to deal with just looking at the bone scan so to start there. Giving him 6 more weeks off before reshoeing and trotting U/S.

                                    I just don't know what is next...he got off the trailer at home after the 4 hour trip and he was obviously visibly lame. I guess injections? The vet wants him to start on equithrive. I don't know if adequan or pentosan would help.

                                    Comment


                                    • #19
                                      Did these things light up on the soft tissue or on the bone phase? Or both?
                                      The Evil Chem Prof

                                      Comment

                                      • Original Poster

                                        #20
                                        I could be wrong but I believe bony. The images were taken 2 hours after receiving the radioactive isotope.

                                        Comment

                                        Working...
                                        X