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

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

    Hi all,

    My horse recently has come down with a hindlimb lameness. Toe drag, muscle atrophy at top of his hip,short striding left hind.

    it came on rather suddenly...so I don't think it was a pre-existing problem.

    He seems better with rest and is still NQR on first ride after but then goes lame again.

    I DID bring him to a vet (THE Leg vet and he is well known) however I was less than please with his exam...

    I have brought my horse to him previously and discovered severe hock arthritis (but it was fusing as of 5 years ago and he was never lame from it just stiff )

    I believe since my horses previous history with hocks he jumped to the diagnosis. My horse was trotted in hind and presented with a left hind lameness.

    He flexion tested his hock for soreness (but..i also know that flexes the stifle as well..) he was positive and the vet just told his assistants to prepare him for a hock injection and that was it.

    I asked him if the hock should be nerve blocked to make sure that was the problem and he basically said it wasn't necessary.

    and that if it wasn't better after this he probably would need to be retired... which shocked me as this happened quite abruptly.


    He was also prescribed previcox for 10 days.

    he seemed better (but that might have been the previcox) but once I started riding him (still starting slow) he was lame again with what seems like the same lameness.

    I am going to take him to a vet again, but am having trouble deciding if I should go back to this vet, even though he is" THE leg vet".

    I just felt he wasn't as thorough and would hate to spend another $400 if he isn't going to do much.


    it seems as though he has made up his mind that it is the hock and not much can change it.

    Update! post #33
    Last edited by TheHorseComesFirst; Sep. 29, 2013, 06:15 AM. Reason: Update

  • #2
    I would go to another vet. You obviously sound like you lost your confidence in your current vet and as long as you have that gut feeling you will be second guessing what is going on with this horse. A fresh set of eyes and skills may be what your horse needs.

    Comment


    • #3
      Ditto davistina67 remarks. You want a veterinarian who is curious, not predisposed.

      Comment


      • #4
        I hope that for your horse's sake there is more than one THE leg vet within driving distance. Cause that's where I'd be heading.
        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.

        Comment


        • #5
          You are free to get a second opinion. In my experience though, visible muscle atrophy doesn't tend to come on suddenly.

          If it's been 5 years since he's been seen for his hocks I'd want another set of x-rays done.

          As an aside what does your dog have to do with the horse's lameness?
          "Some people are born on third base and go through life thinking they hit a triple” – Barry Switzer

          Comment


          • #6
            Everyone's experience with different vets is different.
            My main go to vet has always been great, however I know people that will NOT go to him as he has misdiagnosed their horses.
            I have vets that I would never go to due to them misdiagnosing my horses, yet for others that is THEIR go to vet.
            Go with whatever vet you feel confident in.

            Comment


            • #7
              If you're not getting satisfaction (and there really are some BN vets who are less than interested in either older horses or cheaper ones, sad to say) you would do well to find the nearest major university with a veterinary teaching hospital and have them do a thorough workup. Because it's "teaching," they tend to do a lot more for a lot less money, they are very thorough, and they'll give you solid diagnostic information to share with your local vet (who should not be put out by your seeking this kind of second opinion.)

              I once went through 3 vets before I could find someone who listened to me when I said my horse was NQR--and on ultrasound, he had a tear in his check ligament the size of a dime! Keep looking, you know your horse best, and good luck!

              Comment

              • Original Poster

                #8
                Originally posted by mswillie View Post
                You are free to get a second opinion. In my experience though, visible muscle atrophy doesn't tend to come on suddenly.

                If it's been 5 years since he's been seen for his hocks I'd want another set of x-rays done.

                As an aside what does your dog have to do with the horse's lameness?

                OOPS! I must have had a brain lapse. I meant horse. Have no idea why I said my dog...though I do have several lol

                Comment


                • #9
                  I would definitely suggest a different set of eyes.
                  "You can't really debate with someone who has a prescient invisible friend"
                  carolprudm

                  Comment


                  • #10
                    It really did confuse me. I thought maybe you were having the dog looked at too. Anyway, I'd still suggest a second opinion and a set of x-rays.

                    Good luck.
                    "Some people are born on third base and go through life thinking they hit a triple” – Barry Switzer

                    Comment


                    • #11
                      From my (still limited) experience in the veterinary industry, experiences like this with a GOOD lameness vet is usually always the result of a miscommunication between the vet and owner regarding the owners goals for the horse.

                      Vets aren't mind readers regarding how far you want to go with a horse (aggressiveness of treatment), what your other option are (do you have 2 younger horses at home, or is it this horse or nothing), or are you the client that goes crying to the Internet when they recommend an expensive treatment for your old horse? They don't know! They try and do the best they can to "read" clients, but clients clients can be really misleading (not their fault, just part of the challenge for everybody). It sounds like this vet made some assumptions that may not be accurate, such as, you're not wanting to retire this horse.

                      Did you do the hock injections? If so, I take it you did not see improvement?

                      What I would do is have a phone call with this vet (not a $400 appointment), let them know you didn't see improvement. Express that you don't want to retire this horse if there are still options because a new horse isn't an option (or what ever the case is for you). You want to find out if he thinks it would be valuable to bring him back for further diagnostics. The vet might surprise you!

                      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.

                      Comment


                      • #12
                        My older horse presented with these same symptoms and we assumed it was her hocks, only to inject them and find a week later that she had EPM. Not to alarm you, but the SAG test is only $38 from the Pathogenes lab in FL and they get you results back in less than 2 days (or at least they did mine - sent it Thurs afternoon to arrive Fri AM, had an answer Sat afternoon).

                        Comment


                        • #13
                          When observed from behind, what is the swing of the left hind. IOW, does it move straight forward or swing in towards or to the midline? Same question regarding the right hind.

                          Comment

                          • Original Poster

                            #14
                            Originally posted by flyracing View Post
                            "From my (still limited) experience in the veterinary industry, experiences like this with a GOOD lameness vet is usually always the result of a miscommunication between the vet and owner regarding the owners goals for the horse.

                            Vets aren't mind readers regarding how far you want to go with a horse (aggressiveness of treatment), what your other option are (do you have 2 younger horses at home, or is it this horse or nothing), or are you the client that goes crying to the Internet when they recommend an expensive treatment for your old horse? They don't know! They try and do the best they can to "read" clients, but clients clients can be really misleading (not their fault, just part of the challenge for everybody). It sounds like this vet made some assumptions that may not be accurate, such as, you're not wanting to retire this horse. "
                            I'm sorry, this was not the case. they asked me what my goal would be for this horse. I told them I would still like to be able to at least do lower level dressage.

                            also unrelated to this lameness : I asked him about stem cells and IRAP for some arthritis he has in is knee, he told me his knee was past IRAP at this point and that doing stem cells is just a way to buy stem cells meaning that it doesn't work)
                            .

                            Asked about magnetic therapy,laser therapy and their recc'd for massage and chiropractic. I do believe they knew I wanted this horse sound and happy and for me to try and keep riding him.

                            Did you do the hock injections? If so, I take it you did not see improvement?
                            Yes, He only did the hock injection in one hock his LH. First Ride fel great only to deteriorate and lameness back on the next ride. (thinking the stall rest w/o riding along with previcox took the inflammation away. as he does get better with rest only to become lame again with work resumed (even slow work). feel as the hock injection had nothing to do with the improvement seen on first ride after vet.


                            What I would do is have a phone call with this vet (not a $400 appointment), let them know you didn't see improvement. Express that you don't want to retire this horse if there are still options because a new horse isn't an option (or what ever the case is for you). You want to find out if he thinks it would be valuable to bring him back for further diagnostics. The vet might surprise you!
                            Yes, I will do this.

                            [QUOTE]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.[/QUOTE

                            Thank You for telling me this. I learned something new.

                            Comment

                            • Original Poster

                              #15
                              Originally posted by Rick Burten View Post
                              When observed from behind, what is the swing of the left hind. IOW, does it move straight forward or swing in towards or to the midline? Same question regarding the right hind.

                              From memory (which might not be that great so take it for what it is worth)

                              is that he "tight rope walks" more his LH than his right. (to me he brings the leg out away from his midline on takeoff and brings it in further toward his midline upon landing. (hope my explanation makes sense)

                              However, I will have someone trot him in hand for me today so I can refresh my memory.

                              Comment


                              • #16
                                I second the suggestion of taking your horse to a veterinary teaching hospital if there is one in your area.

                                I ended up taking my horse there after 3 months of a toe-dragging, NQR, muscle atrophy lameness that my local vets did not/could not address. I scheduled an ultrasound because I needed to know what was going on in order to properly treat him. Turns out he had fractured his pelvis which I believe they knew as soon as he walked off the trailer!

                                You will usually leave there knowing what you are dealing with and a plan to help it. Good luck!
                                "The greatness of a nation and its moral progress can be judged by the way its animals are treated." --Ghandi

                                Comment


                                • #17
                                  Originally posted by TheHorseComesFirst View Post
                                  From memory (which might not be that great so take it for what it is worth)

                                  is that he "tight rope walks" more his LH than his right. (to me he brings the leg out away from his midline on takeoff and brings it in further toward his midline upon landing. (hope my explanation makes sense)
                                  This is one indicator of a stifle injury.

                                  Comment


                                  • #18
                                    I second Rick.

                                    You need to get this vet, or another vet, to investigate stifle issues on that leg. I spent nearly $1500 on hock diagnostics and injections for a gelding I used to own that presented similarly. When it didn't resolve I took him down to the equine hospital and they diagnosed stifle issues in about 10 minutes with a single flexion and a set of x-rays.

                                    It was a very very arthritic stifle and that while I felt the lameness had come on suddenly it likely had been slowly building for a while before it was visible to my (at the time) uneducated eye. Get another opinion and insist that that they look at the stifle.

                                    Comment


                                    • #19
                                      Originally posted by risky business View Post
                                      I second the suggestion of taking your horse to a veterinary teaching hospital if there is one in your area.
                                      Well, I live in a community with a veterinary teaching hospital and I wouldn't take a dead horse in there, let alone one who is on its feet and in need of competent, quality veterinary care.

                                      Comment


                                      • #20
                                        Ouch Rick! Veterinary teaching hospitals have a job to do, and that is teaching future veterinarians. It is a very broad spectrum, "All creatures great and small".

                                        So! If you have a horse in need of a sports medicine specialist, a veterinary teaching hospital is not where you want to go.

                                        They can't all have a Dr Moyer on staff. Or a Jacque Jenny (RIP), in the surgery suite.
                                        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.

                                        Comment

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