Any spare wisdom?? **LONG**

[Cliqmo]

Hi Guys I wonder if anyone can offer any wisdom regarding what I'm supposed to do with my boy please?

For those who haven't read my posts before he is a 17hh+ 4yr old who I brought in a very sorry state last September from a lovely lady who, I subsequently discovered, got him from Priddy Fair 1mnth before

Regardless of his sketchy past everything had been going well and I posted a thread about his great improvement http://www.horseandhound.co.uk/forums/sh...&PHPSESSID=
Clearly however this self indulgent post jinxed me because since this time Bentley has officially 'crocked' himself in the field

and various vets trips later we find a counter-rotated pedal bone in his near fore

The vet and farrier agree it was probably due to a soft tissue injury in the field (although this had not been formally confirmed with an MRI because he isn't insured I haven't got the money to pay for it

) but he has had wedges and gel pads fitted to help the rotation and I have been advised by the vet to rest him as you would for a soft tissue injury- we tried field rest but as a playful 4yr old this wasn't working and he remained very lame

so he has been on box rest for about a month now with me grazing him in hand for 20-30mins twice a day.

The reason I need your help is because, if I'm honest, I'm struggling to cope financially and emotionally with the pressure of the situation and I don't know what to do for the best

My poor boy is currently kept at livery in a 12x12 wooden stable (standard size I know), but it means the box is small relative to his size and, being wood, is inclined to be stuffy (read miserable place to be on box rest!) and he is only allowed out in hand for up to an hour a day

I am working two jobs to help pay for the extra costs we are accruing in vets fees, farriers fees, additional supplements and the additional hay and straw we are using as a result of the box rest which means, apart from being constantly knackered, that my OH is fed up with the lack of time we spend together and the lack of funds to do anything else

To make matters worse, probably because of his miserable existence, Bentley has lunged about on the end of the rope twice this week (totally out of character) and even tried to kick me in the head

today he pulled free from me and went absolutely loopy (fortunately in the sand arena) but he was clearly still very lame so all the hard work seems to have been in vain

I just feel really disenchanted with the whole situation, I have no point in time to work on getting to and no 'significant improvement' that can be seen and cherished to bolster me along- I mean what happens if he is still lame in 3mths? 6mths? 1yr?!!...at what point am I supposed to recognise that he might not get better?? I know soft tissue damage is a slow recovery but without an MRI how do I know that what he has is actually curable at all?

I have to admit I have found myself wondering recently whether he should be PTS because as a commonly bred poor starter with a crocked foot I'm really not sure he is ever going to amount to anything and I think I might be wasting my time and money chasing a pipedream

Thanks for reading, any suggestions would be much appreciated.

 

[pixiebee]

I hope ypu dont mind me asking, but why isnt he insured if you cant afford vets fees???? Im not being rude-just curious?

 

[Flame_]

If you can't afford to treat him, PTS, but then do not go out and buy another because that is just as likely to need vets fees paying! If you can afford to treat him you can either choose to pts or treat him, make some management alterations, be very patient and hope for a good outcome. What sort have prognosis have the vets given him if you can get on top of the re-hab? What is the likelihood of him coming sound?

 

[Cliqmo]

He is insured for third party damage etc but not vets fees because when I brought him I took the decision not to get him covered for that element- this was because I have spent many thousands of pounds on insurance over the years and never used it so thought instead I would save the insurance costs and put it in a 'just in case' fund... sadly with our dog needing an operation on her eye earlier this year and the costs of all Bentley's diagnostics to date there is not enough in the pot to fork out for an MRI. Naturally now I massively regret the decision not to get him fully insured but at the time it was done in the best of faith.

 

[Dogstar]

I would ask the vets if they could put the MRI scan on account and pay it in instalments. It is awful not knowing the likely outcome. The vets will help you decide though, when all options are exhausted. It sounds like you need to find somewhere else to keep him eg a menage/starvation- sized paddock or you will get injured, its not worth the risk carrying on.

 

[Flame_]

Would taking the shoes off be at all possible? If the horse can cope with it I believe this is just as likely, if not more likely, to fix feet problems than complicated remedial shoeing, and it would save you a fortune.

 

[Ravenwood]

You sound really fed up with it all

And I guess it does look bleak at this moment in time.

My friends pony also has a slightly rotated pedal bone which happened mysteriously, she has never had lammi as agreed by the vet and farrier. Hers was detected by xrays and not MRI which I think is much cheaper. Perhaps you could discuss this with the vet? Also, this pony is turned out with glued on plastic shoes (very expensive

) and not on box rest.

Have another chat with your vet and see if there are any other ways of managing him. Chin up

 

[Cliqmo]

[ QUOTE ]
If you can't afford to treat him, PTS, but then do not go out and buy another because that is just as likely to need vets fees paying! If you can afford to treat him you can either choose to pts or treat him, make some management alterations, be very patient and hope for a good outcome. What sort have prognosis have the vets given him if you can get on top of the re-hab? What is the likelihood of him coming sound?

[/ QUOTE ]
Thanks for your response, the vets would only give a 'guarded' prognosis based on the rotation of the pedal bone and because he cannot be sure of the extent of damage to the soft tissue...

 

[Lippyx]

Oh sweetie, what a horrid situation! I do know how you feel though. When I had my last horse on loan, within a month of having her she got an abscess and for the next few months I was nursing a very lame horse (who wasn't even mine!) and considering she was the first horse that was completely MY responsibility, it was not whta I really wanted! I was looking for something to compete on not keep on box rest etc!!
After Farrier visits and vet visits (and xrays) she soon becoame sound, but at this point, I had decided she was too much of a liability (it wasn't her fisrt and only abscess, and had very flat feet, that still needed correcting) I made the decision, with the help of OH to give her back, and look for something more suitable!

What I think I am trying to say is no will think you are a bad person realising that you cannot afford to have a sick horse! I know I will get shot down for this, but if you really are struggling then you should think about your future with him... You have to think what if something more serious happens to him, and you can't afford the vet bills or insurance, what then?

I know horses are prone to illness etc, but there is no point in starting out with a sick horse.... do you see what I mean?

I am now working towards paying off debts, so when I do get a new horse, if something does go wrong, I will have more money to myself to pay for emergencies etc!!

I hope this has helped a little!!

 

[0ldmare]

Poor you what a horrible position to be in

Could you talk to your vet about paying for an MRI over a 3, 4 or 5 months so you could find out what exactly is wrong.

Or can you talk to your vet about turning him away instead of box rest. it might not be perfect/ideal but it might be a lot better than you getting kicked in the head or him going for a mad broncing session at regular intervals and undoing all your good work!

 

[Cliqmo]

[ QUOTE ]
Would taking the shoes off be at all possible? If the horse can cope with it I believe this is just as likely, if not more likely, to fix feet problems than complicated remedial shoeing, and it would save you a fortune.

[/ QUOTE ]

Thanks for your reply, interestingly he was being worked barefoot as he has tremendous feet, these remedial shoes are his first set. They were recommended by the farrier and endorsed by the vet in the hope that we could reverse the rotation of the pedal bone and get the solar surface back to the normal angle.

 

[Annagain]

You have my sympathy as mine is also crocked with soft tissue damage and bruising to pedal bone - currently on week 9 and although he has improved since the original injury he's no better now than he was at week 4 (thought he was better rode him for a bit too long (vet prescribed gentle exercise) and back to square 1). Luckily mine is quite sensible/lazy so vet is happy with him on field rest and he's plodding round the block twice a week so at least I get to ride, albeit for 20 mins in walk, but I know how frustrating it is - and your situation is worse than mine. I'm considering trying box rest to see if that helps as even though he's not going mad in the field and he's back to 90%, that last 10% back to soundness just isn't happening. He hates being in though especially by himself and all the others are out 24/7 so I don't know what effect it would have on him.

Can you maybe turn him out in a small area, maybe with a nice quiet companion so he doesn't have too much room to go mad but it's a nicer place for him to be and a bit easier for you? There must be a little pony who needs to come off the grass who could keep him company or an oldie who wouldn't mind a small paddock. It doesn't solve all your problems but it would give you a bit of breathing space to make any other decision with a bit of distance and clarity.

 

[Flame_]

Only other suggestions are, for the exercise use a bridle if you aren't already, or if you are then consider a chifney. Also speak to the vet about whether you could give him a low dose of sedalin or a couple of ACPs which are cheaper, for when you are walking him out. Make sure he has ad-lib low energy hay and not much else feed wise.

Plus, tell your OH you took on responsibility for this horse and this is just the way it goes sometimes, so he should stop moaning.

 

[Cliqmo]

Thanks for all your replies guys, I will certainly speak to the vets about about putting the MRI on account and paying it in installments- at least then I will have a clear direction/decision!
I will also speak to the YO about lending me one of their horses as a 'turnout buddy' for Bentley, and see if that keeps him any quieter-although because the horses are all quite elderly I'm not sure inflicting a cross youngster on them will go down terribly well!!

 

[Tickles]

If the worst comes to the worst, or even if he just needs to be turned away for a while, I'd suggest seriously considering a loan or, better, fixed cost share next time. Will put much less strian on finances, wellfare of horse if anything goes wrong & relationship etc, etc!

Very best to you & horsey, hope the MRI provides some positive news!

 

[Happytohack]

Don't beat yourself up about the insurance - not all insurance companies will pay for MRI scans anyway.
The first thing that sprang to mind when reading your post was I wonder if the gel pads & wedges have actually made your boy's lameness worse? I have a horse who had rotated pedal bones and he was fitted with pads and it definitely made him a lot worse. My farrier then fitted Imprint shoes and there was an immediate improvement. Another friend with a horse with rotated pedal bones and very dropped soles also had pads fitted and again, these made the horse worse. The pads can actually cause more pressure. It would be worth discussing this with your vet & farrier. Imprints are expensive though - £100 a pair.
I have two large horses and a 12 x 12 box isn't big enough. Can you make a large pen to turn him out in all the time? Or can you move him somewhere with a bigger box?
Have a long, honest chat with your vet about your horse's likely long-term prospects and see if it is worth carrying on.

 

[Marchtime]

I've been in your position so I know how it feels. Sammy tore his collateral ligament about seven years ago now. Back then MRI's were new and few places had them. We tried all the standard treatment for nine months including box rest and steriod injections before finally getting referred to New Market. MRI confirmed irrepairable damage to the ligament. He was pts a month later. Now with hindsight I wish we'd called it a day sooner. He was an 8yr old TB and by the end he'd lost so much condition and was very depressed.
Jesper was diagnosed with damage to his collateral ligament two years ago following MRI and a much quicker diagnosis. The vets suggested box rest, however he's not the sort to take to thsi and like yours becomes dangerous to handle. His damage was caused by his pedal bones lying at the wrong angle. We turned him away for nine months. The difference between him and Sammy was that Jesper was not in much pain and more than happy to amble round a paddock. He did still prat about but I had to accept either it would heal or it wouldn't. He returned to work after nine months but later retired due to a whole catalogue of problems.
In your position I'd seriously be considering the welfare of your horse. He's very young with a guarded prognosis. Is he happy in himself or depressed? Is he in pain constantly? If you can get an MRI on account brilliant but what you might have to accept is often MRI's only confirm diagnosis and don't change the treatment plan, so I think you need to have some idea of what outcome would be acceptable. Good luck, PM me anytime.

 

[Darkly_Dreaming_Dex]

I agree with Marchtime- Our 8 year old clydie x went lame 18 months ago. He is fully insured. We started with xrays (clear) nerveblocks (came sound on coffin joint) injections- steroid, Adequan, Cartrophen (not tildren as not recommended for coffin) IRAP. Everything made a small improvement for a few weeks then he was pointing his foreleg again and lame. My vet and the hospital advised us AGAINST an MRI as both said it was a lot of money for "a pretty picture not a solution" and advised us to go for an arthroscopy operation instead- similar amount of money.

We dithered for a couple of weeks as my OH really didnt want his horse to have a GA but then we found Jacob on 3 legs in the field and we had to rush him to the hospital. Xrays were clear, nerve blocks reconfirmed it was the coffin area, so they operated. The arthroscope is inserted through 2 small holes (on normal horses so of course Jacob had to have 3) just above the coronet band (for coffin joints). We saw the fascinating video slide show of the op afterwards. They found a tiny (5p sized) bone chip (which the surgeon said would NOT have shown on MRI) and the cartilage was badly torn off the coffin joint (that would have shown on MRI) she tidied up the damage and was also able to visually inspect for soft tissue/ligament/tendon damage and all was clear- no tears/holes/lesions

We brought him home and he had 4 weeks total box rest- he was a nutter so we put him in the double field shelter (12 x 20) with the front half boarded, hung a huge haynet at the front and he would chat/groom with his friends who came over to nick his hay. This really calmed him down and we were allowed to put him in the tiny grass pen alongside for a couple of hours a day for the 4 to 6 week period. Jacob was really well behaved at first but then got cross and started flinging himself around culminating in him jumping out over the 4' electric wire

He was given the ok to go out as he is normally quiet in the field. He has now been out for 8 weeks but is still lame

even the vet is upset as there is no reason for him to still be lame yet he is. I have resigned myself that he is a happy field ornament and as my OH cannot ride for a year and we have 3 others, there is no pressure for him as a riding horse.

I wish you all the best- its a horrible situation to be in. I have to admit i would be tempted to take his shoes off and chuck him out for a year (as long as he and vet is happy about it) and then reassess. Dr Green is a very underrated cure for problems.

We are now out of (and maxed out) the insurance, PP are wriggling on the final hospital bill and all further bills will be paid by us so insurance isnt the magical financial solution some may believe it to be. I would also be VERY clear with my vet that YOU not insurance are paying his bills as that can make a massive difference

 

[Cliqmo]

Thanks for the replies everyone and in particular thanks for the personal experiences- they are interesting (if a little disheartening

) to read. The vet is aware that I am paying the bills myself and put forward the suggestion of an MRI whilst advising us of their shortfalls (notably that it is only a 'diagnostic tool' and that it cannot guarantee a diagnosis let alone a solution) which is why we opted against having one at this stage.
Bentley is very happy and well in himself (the lunging and bucking definitely comes across as pent up energy and frustration) and when he is 'showboating' around once he has got away from me he looks amazing (sound!!)- it is only once the adrenaline has worn off that he remembers it hurts

I will speak to the farrier and the vet to see if turning him away is a viable option (and also my parents about keeping him at their Farm again

) ; although I suspect already that they will all say "it depends on the extent of the damage" as to whether (A) he will ever get better and (B) whether the improvement will be best facilitated by box rest or field rest... which means I really ought to consider an MRI/arthroscopy before doing anything else... hmm I need to speak to the vets I think!!...

Thanks again for your help and advice on this though, it has been great to air my concerns and to read through your advice. .

 

[AmyMay]

Ali, not all horses can cope with the wedges, and I would discuss with your farrier and vet changing to heartbars and gel pads. You may remember that I posted to say that my horse was immediately improved with this set up.

I had a long chat with my farrier the other day and was discussing the merits of wedges vs heartbars - and why he had gone with the hearbars and gel pads. He was of the opinion that many horses do not cope well with the wedges. And the hearbars and gel are a far less dramatic, but far more immediate 'prescription' for most horses.

If he were my horse, the wedges would be immediately off.

EDT: having read more of this thread -- I see that these are his first set of shoes?? I'm horrified that he's been fitted with wedges, and think you have been very, very badly advised.

Get them off and heartbars on. Don't worry about the MRI - get the shoeing right and it should become academic.

Is he on Bute?

 

[Cliqmo]

Hi AmyMay,

Thanks for the info- I do recall you saying about wedges vs heartbars before. Excuse my ignorance but (as you spoke to your farrier about it) what are the main differences between heartbars and wedges in terms of the way it effects the foot? I was of the impression they had much the same effect?
I will ring my farrier immediately but was wondering what you have been told as a point of reference! No Bentley is not on bute as the vet would like to see him come sound and was keen not to disguise the lameness by using painkillers. Throughout the course of this issue he has consistently come sound whenever nerve blocked or when he has been given bute though, if that helps?
How is yours doing now btw??

 

[Marchtime]

From my understanding wedges will raise the heel of the foot whereas heart bars will simply support it without dramatically changing the angle of the foot and soft tissue within. Have to agree with AmyMay - I didn't pick up on this initially but we've steered clear of wedges with Jesper for fear it would cause further damage. Gel pads were the miracle cure and largely responsible for his return to work originally.
With regards to the operation that I can never spell *arthscoprapy?* I'd talk through with your vets. It tends to have a better success rate in older horses where issues such as wear and tear or bone chips exist, but is not worthwhile in pure soft tissue damage cases.
If you think about turning away I'd consider buting in the short term as it will not only help him be comfortable but also help reduce inflammation.
As a final thing whilst box rest is clearly advised I think you have to think long term about your horses welfare. The vets and I agreed not to box rest Jesper after the initial six weeks as I believed long term box rest would cause him to lose weight and stress and this wouldn't be helpful. In my opinion in most cases if a horse is going to come sound then a year in the field will work just as well as six months box rest. I'm no vet though.

 

[AmyMay]

[ QUOTE ]
From my understanding wedges will raise the heel of the foot whereas heart bars will simply support it without dramatically changing the angle of the foot and soft tissue within.

[/ QUOTE ]

Exactly, which is why my farrier didn't want to put them on, even though this was the initial advice from the vet. However, they consulted with each other - and vet went with the farrier preference. Interestingly my vet did say (when he came out to review the horse, that his heart would have been in his mouth if he had been shod with the wedges, because some horses can have such an adverse reaction to them).

Thumper went from absolutely buggered to practically sound upon being shod with the heartbars and gel. And I simply can't understand why your vet is not looking to an alternative, as the wedges clearly aren't working.

Once Thumper had been shod the vet then wanted him on a low dose of Danillon for 5 days, to assist with any soft tissue inflamation that may exist. Remember Bute/Danillon is not just a painkiller - but an anti inflamatory also. And in order for treatment to be successful the aim is always to reduce inflamation as quickly as possible. I also don't think it's acceptable for a horse to be left in pain - and would insist on some pain relief if the horse is as lame as you describe.

Because Thumper's lameness was resolved so quickly he was not box rested, and two weeks after initial diagnosis I was back on board.

We're now trotting - and he's as sound as a pound.

 

[Cliqmo]

I called the farrier earlier but got his apprentice as he is (typically) away until Monday- I will centerainly be on the blower on Monday though, asking for a switchover to heart bars and investigating his decision further.

Amymay I'm so pleased to read your boy is on the mend!!