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right front lameness/diagnostics? need opinion

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  • right front lameness/diagnostics? need opinion

    not sure how i feel about this and wanted to get some input.

    horse had front right coffin and pastern injected. same on left. when the right front was blocked 60% improvement was noted immediately and at that point injections were done and no further blocking occurred.

    the horse is more then happy to do its intended job, and seems happy and relaxed. plays in pasture and is not favoring any leg. Movement seems undisturbed.

    While under tack the horse is almost 100%, occasionally slight lameness felt/observed in right front. vets have observed horse under saddle numerous times and agree that horse looks totally fine while being ridden. Does not favor any leg, lead, and jumps comfortably. tracks up even with both and front also travels evenly. no shortening of stride is observed.

    when horse is lunged on hard footing, she is 100% sound.
    medium footing 1/5 on the right front
    deeper footing 2/5 right front (pre and post injections)

    This right front has been monitored for almost a year now, not for any particular reason, just something we choose to keep an eye on and if any changes occurred, we would be able to hop right on it. originally our feeling was the horse seems more comfortable then ever, has no impact on its job/athletic performance and seems content. Normally this is a horse that will tell us if something is wrong.

    horse was re checked 2 weeks after the right front pastern and coffin injections. no improvement noted. vet wants to go ahead and do further diagnostic testing, which i am not opposed to. vet thinks there may be a soft tissue injury in right front.

    however, i am more then willing to do further diagnostics so at least i know what is going on. But this is where i am unsure of what to do.....if the horse seems totally happy and content and not in any pain, do we treat it? this is a horse that will NOT do well on stall rest and will get very agitated and upset if not turned out and ridden daily. Horse is in shape. Depending upon what is found, stall rest will most likely be recommended as part of treatment as well as shockwave and or irap.

    But, do we go ahead and treat it? My instinct says no, just continue on and if it becomes a issue under saddle and if horse becomes more uncomfortable, then yes we will treat it. but i feel like putting this horse on stall rest is the worse thing mentally. i also suspect whatever injury there might be, is older and may not have been properly treated. looking back in the medical records, right front lameness was observed back in 2007 and 2008. Owners at the time did a round of shockwave and 2 weeks stall rest and vet reported 100% improvement and 0/5 on hard, 0/5 on medium, and 0.5/5 on deep footing in right front.

    so, basically what i am asking is what would you do/how would you go about treating this?

    would it be wrong/cruel to not treat whatever is found depending on severity? the horse is happy and performs intended job with ease. infact, horse appears to be the happiest and most comfortable it has ever been in the past 5 years!

    is it smart to still do diagnostics anyways so we at least know where we stand and can use them as a comparison in the future should anything arise?

  • #2
    1. How old is this horse? You don't mention it.

    2. What exactly IS its job? You haven't said.

    3. Who tends to this horse on a daily basis? How skilled is this person? Is it a just a job, or is the person a real horseman? Who oversees this person?

    4. How often is it asked to work? At what level? Who benefits?

    5. What are your goals with this horse?

    6. How much are you able to spend?

    Does this horse have an advocate, whose priority it is to put the horse's welfare first? Whoever that person is is the one that you should be speaking with, not a bunch of internet strangers who have never laid eyes on this animal.

    Owners, trainers, and veterinarians can either be a horse's best line of defense or worst enemies, depending on whose interests are being served, and often the line between the two camps becomes blurred. In this day and age, interventions are available that could put you on either side of that line, not depending on what they are, but instead on why you might elect to use them.

    From your description, and in the absence of answers to the questions above, you might want to think about whether you might be heading into no-man's-land.
    Inner Bay Equestrian


    • Original Poster

      1. 14
      2. jumper (1.30)
      3. person is a real horseman. i also tend to horse on daily basis. horse has had top training from professionals in us and over seas. Top vets are used and a wide array of them to have multiple eyes and different specialties come into play.
      4. worked 5-6 x a week. he really does love his job. jumps 1x/week when not showing. schooling anywhere from 1.15-1.40
      5. a/o jumper
      6. $ is not an option. i would be more then happy to do all diagnostics and treatments, but i am not sure if he would be a good candidate for stall rest. at 14 he is older and it would be much harder to bring him back and get him back into shape. and honestly i don't think he is uncomfortable.

      i myself am the horses advocate. i also trust my vets. i want to do what is right for him at whatever measure. but i do feel stuck in the middle. vets obviously want to treat whatever injury may be there, but knowing this horse, I'm not sure if putting him on stall rest and out of work and then rehabing him would be good for him. he is a high strung animal and taking him our of work, which he loves, would be hard for him.

      anything else i seem to have left out that may make things a little clearer?


      • #4
        Originally posted by rapazzini09 View Post
        My instinct says no, just continue on and if it becomes a issue under saddle and if horse becomes more uncomfortable, then yes we will treat it. but i feel like putting this horse on stall rest is the worse thing mentally.
        I believe you have answered the question, your just not listening to yourself.

        I do not believe there is a right or wrong answer here, and unfortunately no guarantee that following either option path is going to net the best results, but clearly you feel strongly about the horses tolerance for layup and I assume for good reason. Given your personal involvement, knowledge of the situation and understanding of the horse you have as strong a case for following the above option as any.

        To many this may seem as Disney special as can be and perhaps hard to believe, but I have seen a couple horses over the years who simply lived to work. One pretty much the same scenario as the horse in question, a couple years older, and slated for retirement. It took about a month for him to figure out that he was not going back to work, and it was a very fast progression into major depression from there. He stopped eating, lost interest in pretty much anything, and just deteriorated, mentally and physically instantly. Everything that could be done was done for him medically with no results. What did work was putting him back to work. He competed for another 13 years, and retired in his 29th year, and I guess at that time he was ready to slow down but not completely as he still did 5 mile trail rides a few times a week to keep him happy for the next 10 years.


        • #5
          You are merely speculating about whatever treatment the horse may need. Soft tissue does not automatically mean stall rest. And how do you know the horse will become suicidal if she can't do her job?

          If the owner is a true horseman as you claim, he would never leave such a decision up to a third party such as yourself.

          Furthermore, there are rehab facilities that specialize in this type of program, as well as long-acting sedatives. The horse will let down like race horses do if taken out of work.

          2/5 in deeper footing--that's a jumping arena.
          2012 goal: learn to ride like a Barn Rat

          A helmet saved my life.


          • #6
            I would say see what the vet says. If it would only be two weeks of stall rest, thats not too bad. I know some people might not want to do it but there are drugs that help with stall rest.


            • #7
              I would want further diagnostics done. You mentioned that the horse had been blocked and the lameness improved. What about ultrasound, x-rays…These are not expensive options and could lead you to some better treatment plans that do not require much stall rest.


              • #8
                Originally posted by rapazzini09 View Post
                6. $ is not an option. i would be more then happy to do all diagnostics and treatments, but i am not sure if he would be a good candidate for stall rest. at 14 he is older and it would be much harder to bring him back and get him back into shape. and honestly i don't think he is uncomfortable.

                anything else i seem to have left out that may make things a little clearer?
                Do you mean that spending more $$ is not an option, or did you meant that money is no object and the owner will spend whatever is necessary for the horse's well being?

                14 is not "older," IMHO.
                2012 goal: learn to ride like a Barn Rat

                A helmet saved my life.


                • #9
                  i would look for further diagnostics but I would wat to try blocking behind aswell to see what happens. My own mare was showing a similar issue last year but it was actually her hind suspensories that were injured. the front lameness was just from compensatory movement hence why we couldn't cure it without fixing the back end. We treated with steroid injections in both hind suspensories and haven't looked back....and my mare was 15 being treated!


                  • #10
                    We had one who was intermittently NQR. When we finally went to the lameness surgeon, he found bilateral suspensory core lesions. The horse kicked through the stall wall after 2 days of stall rest. The surgeon then recommended paddock rest for a few months followed by a rehab program that involved lots of walking under saddle, then trotting under saddle. The horse was completely sound after the rehab and did a few years of childrens jumpers. 12 years later, he is still sound. We could have kept competing him when he was NQR, but I am glad we did the diagnostics and rehab plan. I'm also glad the surgeon agreed that stall rest would not work for this horse. Not every soft tissue injury needs stall rest.


                    • #11
                      I would do the diagnostics and see what comes up. If there is something that needs rest you could look into rehab facilities with an underwater treadmill since you said money is no problem. That way the horse would still be kept in shape while not stressing the limb in question. Look into going to a vet or university with a strong sports med program and have MRI/CT, nuclear scintigraphy available if you want an absolute diagnosis.


                      • Original Poster

                        thanks everyone. went ahead and did the mri and it confirmed what we saw on the ultrasound. she is doing 3 rounds of irap (sp?) and 3 shockwave treatments.
                        we will go from there. as of now, she is on hand walking for the next 6 weeks but if we decide to do more treatment after the irap and shockwave is done, i have been in contact with a rehab facility in california so we shall see what happens.



                        • #13
                          I might talk to my vet or farrier about a trial of shoeing the horse in front leather pads with a Silicone Packing.

                          It may help support a diagnosis of caudal heel pain syndrome.

                          Putting the horse on isoxsuprine is another relatively harmless test one might try in conjunction with the pads as long as the vet approves.