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Vet not at thorough as I would like. Update! #33

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  • #21
    Did your horse get its hocks injected?

    Comment


    • #22
      Originally posted by merrygoround View Post
      Ouch Rick! Veterinary teaching hospitals have a job to do, and that is teaching future veterinarians.
      Then I fear for the horses that may come under the gentle ministrations of graduates from this University.

      Comment


      • #23
        Originally posted by flyracing View Post
        On the note of blocking the hocks, this is an intra-articular block. Many vet avoid doing IA blocks when possible, because there is risk every time you enter a joint. Potentially a greater reason is The vet would block the joint, then the horse would have to wait to have the hock injections (not enough space in the joint to do both at once). IA blocks are often equally as expensive as the steroid injection, so it is often reasonable to save the client the expense and use the steroid injections both diagnostically and as treatment.
        FWIW, you can inject a blocking agent and a steroid and/or HA at the same time. My old vet used to do that if she was pretty sure where the issue was, during a lameness exam (assuming there was adequate joint space for all of it). On the odd chance that the lameness didn't resolve, the exam continued.
        As Peter, Paul, and Mary say, a dragon lives forever.

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        • #24
          Originally posted by Rick Burten View Post
          Then I fear for the horses that may come under the gentle ministrations of graduates from this University.
          I used to live there too, spent some of my college career there, and totally agree with that statement. That University is not known for their equine department. Do some research, get recommendations before bringing a horse to the closest VTH.

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          • Original Poster

            #25
            Originally posted by Fharoah View Post
            Did your horse get its hocks injected?
            Yes, The vet did inject my horses hock that was thought to be the culprit.

            I believe he gave two injections in the LH hock one at the TMT joint and one on where the location is called "Jack".
            Last edited by TheHorseComesFirst; Sep. 29, 2013, 07:18 AM.

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            • #26
              Are you in an area with a lot of good equine vets? Or is this vet pretty much the only lameness expert in the area?

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              • #27
                Originally posted by Rick Burten View Post
                Then I fear for the horses that may come under the gentle ministrations of graduates from this University.
                Unfortunately, there does not appear to be any such thing as anew graduate who is ready to go out and work on their own. Even those who grew up in a horse barn need to learn to shut up, look, and listen And learn to work without all those marvelous machines.

                The original suggestion to use a VTH came from a poster from Pa., where they have an equine facility & faculty at NBC to be reckoned with.
                Some riders change their horse, they change their saddle, they change their teacher; they never change themselves.

                Remember the horse does all the work, we just sit there and look pretty.

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                • #28
                  Originally posted by TheHorseComesFirst View Post
                  I believe he gave two injections in the LH hock one at the TMT joint and one on where the location is called "Jack".
                  Sounds as though the vet suspects osteoarthritis/DJD of the distal tarsal joints. The location you refer to as "Jack" is on the inside of the hock where the cunean tendon crosses the bones of the distal part of the joint. When a cunean tenectomy is performed, it is often referred to as "Cutting the Jacks". Often, the distal joint(s) will fuse either naturally over time, or by by chemical arthrodesis.

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                  • Original Poster

                    #29
                    Originally posted by Rick Burten View Post
                    Sounds as though the vet suspects osteoarthritis/DJD of the distal tarsal joints. The location you refer to as "Jack" is on the inside of the hock where the cunean tendon crosses the bones of the distal part of the joint. When a cunean tenectomy is performed, it is often referred to as "Cutting the Jacks". Often, the distal joint(s) will fuse either naturally over time, or by by chemical arthrodesis.
                    Yes, hock arthritis was diagnosed in my horse about 5yrs ago by the same vet but he said "It is so bad, it is good. As he is about 90% FUSED. " back then he said we probably couldn't get a needle in there (so my horse' s hocks were not injected at time of diagnosis)

                    I referenced the fusing and what he said at this past visit (2013) and he said "yes, but they are not all the way fused"

                    Which perplexed me because it was completely different than what he told me before...

                    I am not sure if he had trouble injecting his hocks or not. I did ask if we should take new x-rays but he told me "why x-ray something we already know is there?"

                    Thank you for all of your informative replies.

                    Edited to add: this was the one and only time his hock has been injected since diagnosis. The other hock has never been injected.
                    Last edited by TheHorseComesFirst; Sep. 29, 2013, 07:30 AM.

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                    • #30
                      Toe dragging says "stifle" to me.

                      The muscle atrophy takes some time.

                      Look, if you injected the lower hock joint, then you can more or less take that out of the running as a candidate source of pain.

                      Find the next best lameness vet and ask him for a diagnosis-- knowing what you know now. Also, it's better to do that sooner rather than later since steroids have a half-life.
                      The armchair saddler
                      Politically Pro-Cat

                      Comment


                      • #31
                        Originally posted by TheHorseComesFirst View Post
                        Yes, hock arthritis was diagnosed in my horse about 5yrs ago by the same vet but he said "It is so bad, it is good. As he is about 90% FUSED. " back then he said we probably couldn't get a needle in there (so my horse' s hocks were not injected at time of diagnosis)
                        So if he couldn't get a needle in back then, how was he able to do so now? IMO, something smells rotten in Denmark...
                        I referenced the fusing and what he said at this past visit (2013) and he said "yes, but they are not all the way fused"

                        Which perplexed me because it was completely different than what he told me before...
                        Absent a rad, how did he know this.
                        I am not sure if he had trouble injecting his hocks or not. I did ask if we should take new x-rays but he told me "why x-ray something we already know is there?"
                        Well, gee, let me see. Perhaps to see if the joint is fully fused? Or, perhaps to compare now with 5 years ago? Or perhaps to see if the DJD has gotten worse and if so, by how much? Perhaps to see if injecting the TMT joint is even feasable now, and if so, why now when it wasn't 5 years ago? Until you learn/know differently, I suggest you have your BS detector set at 'full alert'.
                        Edited to add: this was the one and only time his hock has been injected since diagnosis. The other hock has never been injected.
                        Sounds to me as though your vet is treating you like a mushroom--keeping you in the dark and covering you with fertilizer. And a popular fertilizer is composted BS.

                        Comment

                        • Original Poster

                          #32
                          Originally posted by Rick Burten View Post
                          So if he couldn't get a needle in back then, how was he able to do so now? IMO, something smells rotten in Denmark...

                          Absent a rad, how did he know this.

                          Well, gee, let me see. Perhaps to see if the joint is fully fused? Or, perhaps to compare now with 5 years ago? Or perhaps to see if the DJD has gotten worse and if so, by how much? Perhaps to see if injecting the TMT joint is even feasable now, and if so, why now when it wasn't 5 years ago? Until you learn/know differently, I suggest you have your BS detector set at 'full alert'.

                          Sounds to me as though your vet is treating you like a mushroom--keeping you in the dark and covering you with fertilizer. And a popular fertilizer is composted BS.


                          Thank you, Rick. I agree wholeheartedly with what you said. I did feel like a mushroom.

                          It sent up a red flag in my mind when he contradicted himself about what he said not being able to get a needle in there 5 years ago and being able to get a needle in now.

                          I also felt like their should have been more diagnostic tests (ie: nerve block,ultrasound,xrays etc.) to rule out other causes and I asked for them but I felt it fell on deaf ears and he already decided what he was going to do.



                          but since everyone in this area sings his praises I thought I might have been overreacting. I don't think I am now.

                          I think I will follow my instinct and call another vet to get a second opinion.

                          I thank all who replied with their thoughts. I apprectiate it!

                          If anyone has anything more to add feel free.

                          Comment

                          • Original Poster

                            #33
                            Update: I had another vet look at him (of course this vet also worked under the other vet when he started out , so might not have wanted to go against him)

                            We did Xrays of his hock and the vet said that the DIT joints looks fused and like it can't be injected via the X-ray but sometimes looks can be deceiving, so he would try to inject it with steroid to see if there is any improvement.

                            He got the needle into the TMT joint but could NOT the DIT joint. He said that he was 90% sure it is the hock. (however if he is fused that well in there I would wonder why there would be pain?)

                            There was NO improvement after injections from this vet.

                            I brought the vet out again to ultrasound the stifle (since I was paranoid ) and he found nothing significant.

                            I have been riding him at a walk on trail to hopefully help strengthen him.

                            He was improving...until he was reset.

                            I am confident that his trim and shoeing are correct I was thinking that the hammering and and nailing might have done something.

                            or he felt well enough to run and overexerted himself is the cool weather.

                            Symptoms:

                            Next day after reset was sore through back and twisting/wringing his LH Hock (hock twisting out and hoof toe twisted in upon takeoff)

                            A audible popping noise was heard while walking going to the right.

                            Puffiness above fetlocks (but first was noticed in LH)

                            When trying to pick up RH he lifts up the LH and acts like he does not want to put it down

                            When trotting he wants to carry his hindquarters to the right while tracking left and right (his LH under his body and the RH out)

                            He also carries his tail to the Left now intermittently

                            If I think of more I will add it. .


                            his symptoms are :

                            Comment


                            • #34
                              SI?
                              "You can't really debate with someone who has a prescient invisible friend"
                              carolprudm

                              Comment


                              • #35
                                Has anyone done a thorough neurologic exam on this horse? If it was mine, I'd be thinking along the lines of EPM because of the muscle atrophy, tight rope walking, the confusion about which leg to pick up, and now the tail being carried to a particular side.

                                Good luck in reaching a diagnosis on your horse. God knows they can be so frustrating!

                                Comment

                                • Original Poster

                                  #36
                                  The vet did the tail pull test and also walking while raising the head. He must have the head, the vet didn't say anything was abnormal during.

                                  Comment


                                  • #37
                                    OP,

                                    Would you mind sharing your location? I may help other posters give you a better veterinary recommendation.

                                    IMHO, it sounds as if you are working with people not fully competent in full-body lameness work up. A lot of those great leg guys get so focused on the normal problems they see (hocks is a big one) that they fail to see the bigger picture. They are fabulous when you have a specific joint or soft tissue injury, but when you have something messy, they don't know what to do.

                                    My guess is that your boy is suffering from a condition higher in his anatomy than his leg...perhaps SI, hip, or pelvic. It would make sense from both what you state as his symptoms, the muscle atrophy, and his being sore from hiking up his leg for the farrier.

                                    If you don't want to list your location publicly, I'd happily accept a PM. I work for a vet and we have contacts nationwide for great specialists.
                                    Strong promoter of READING the entire post before responding.

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