Any ideas - difficult lameness

[holeymoley]

A few of you may remember my other posts regarding splints and arthritis treatment-cartrophen etc. My 23 year old has now flung an extra small spanner for good measure! I'm looking for potential ideas to ask vet about.
For background, I've owned him for 20 years, and he has never had a day lame with the exception of laminitis 7 years ago. He is now arthritic which is what we are treating him for. He had Arthramid in to hocks last year which didn't really do much and Osphos this year as vet has had personally better results with this, especially if we are not targeting a specific area. We are 1 week in to treatment.

Around 2 weeks ago I noticed when I asked him to trot on the road to the field he had a nod. On inspection, he had a small lump around 1 inch and to the side below the knee which made me think it was a small splint. Vet had came out to do Osphos injection and agreed that he was lame in trot on near fore. He hoof tested him, checked for pulses, flexed, had a thorough feel of the leg and couldn't find anything untoward. He asked me to keep his routine the same, keep him turned out during the day to get him moving and let him know how he was 7-10 days later, he said it may be a splint it may not, it may be related to the arthritis it may not. He has still been lame, on a grade of 0-5 I'd say he's a 3. It's only noticeable in trot. Farrier had came out the day after and said he seemed unhappy about something but wasn't sure what, didn't react to anything he tried.

Yesterday I kept him in due to the horrible weather and turned him out in the arena in the evening to stretch his legs. He is definitely sounder, only a very very slight nod in trot if you were to really study him, and certainly much more spritely in coming out the stable. Husband said that this morning he was definitely different coming out. So, I'm now between a rock and a hard place! He should be out walking to help the arthritis but he seems to repair whatever the issue is if he's kept in. I'm now stumped with what it could be that's causing the lameness. My thoughts-

1. Hoof Abscess- certainly not prone to them and not worsening quickly enough, still happy to walk and weight bare so highly doubt it's that.
2. Navicular- I don't know enough about this, what are the symptoms? He didn't react to hoof testers but unsure if that would pick anything up at the heel area. Please tell me more as it may be a possibility, I think his shoes should be fitted with slightly more heel support. He was barefoot for a while until I put shoes back on him in the Summer.
3. Strain- Some form of strain on the leg? No pulse or anything, no obvious bowed leg or cuts.
4. Laminitis- Definitely not, it doesn't fit anything happening and I have been checking religiously!
5. Coffin Joint Arthritis- Again I don't know enough about this.

Does anyone have any other ideas? It's coming up to the 'call vet back' stage. He is no longer insured and I'd like to have some areas we could maybe pinpoint or talk over possibilities before deciding if we should x-ray or nerve block etc

 

[AppyLover1996]

The fact that you kept him in for one day and there was a change in the fact that he wasn't as badly lame as he was prior, would say to me that he's pulled or strained something x

Baggs my older lad with arthritis in his hocks and stifles, presented pretty much spot on to what your lad currently is last year x He had a few days rest and then turn out in a small area for a week, and then was back to his usual self

The small bump could be where he knocked himself and is his body's response to it x

I can't see how it would be 1, as I would have thought the farrier would be able to pinpoint if it was abscess like issues causing the lameness - then again, I've known horses to have abscesses and not react to hoof testers etc.....

Regarding the navicular in my limited experience - normally they're lame in both front legs, although one appears worse than the other usually, but if you pop them on the lunge you may be able to see the lameness in both front feet in both directions. They also tend to land with the toe of their hoof first x Regarding heel support, you don't want the toe too long in navicular horses, nor do you want a low heel as that will put excess strain on the hooves in general and exacerbate the navicular symptoms. Not always the case but in the limited experience I've had that is what I've found x

I would go with a nerve block first of all and see where that takes you - normally navicular gets diagnosed by a mix of clinical symptoms, X-rays & MRI scans of the feet (which will show any bony changes, excess fluid and other changes to the structure) and past history - again I can only relate to my small and limited experience with navicular x

 

[eggs]

One of mine was a little similar but without the arthritis complication. A few summers ago he would come out of his stable (rubber matted with bedding) in the later afternoon sound but when bringing in from the field the following morning he would be definitely lame. No obvious heat or lumps and bumps. Box rest for a couple of days and he was completely sound and then was lame again when brining in from the field. In his case it was a deep-seated stone bruise that couldn't obviously be seen on his sole. It took a few months to resolve. This horse did have a very low pain threshhold.

Navicular is something else that could well be in the mix.

 

[New Forests Rock]

I lost a 10 yo NF (my last jumping pony) to navicular when he landed from a drop fence and tore his DDFT badly. Not obvious immediately but was very lame following day. 3 months box rest improved things but MRI confirmed navicular in both feet and in those days prognosis was hopeless.

 

[Marigold4]

The fact that you kept him in for one day and there was a change in the fact that he wasn't as badly lame as he was prior, would say to me that he's pulled or strained something x

Baggs my older lad with arthritis in his hocks and stifles, presented pretty much spot on to what your lad currently is last year x He had a few days rest and then turn out in a small area for a week, and then was back to his usual self

The small bump could be where he knocked himself and is his body's response to it x

I can't see how it would be 1, as I would have thought the farrier would be able to pinpoint if it was abscess like issues causing the lameness - then again, I've known horses to have abscesses and not react to hoof testers etc.....

Regarding the navicular in my limited experience - normally they're lame in both front legs, although one appears worse than the other usually, but if you pop them on the lunge you may be able to see the lameness in both front feet in both directions. They also tend to land with the toe of their hoof first x Regarding heel support, you don't want the toe too long in navicular horses, nor do you want a low heel as that will put excess strain on the hooves in general and exacerbate the navicular symptoms. Not always the case but in the limited experience I've had that is what I've found x

I would go with a nerve block first of all and see where that takes you - normally navicular gets diagnosed by a mix of clinical symptoms, X-rays & MRI scans of the feet (which will show any bony changes, excess fluid and other changes to the structure) and past history - again I can only relate to my small and limited experience with navicular x

Agreed - my experience of navicular is that it is in both fronts but one more than the other. Clearly visible on a 10m circle on the lunge. I tried cartrophen but it had no effect. My horse is on bute. She is better in the summer and worse in wet conditions in the winter. Hope you find what's wrong and how to sort it.