Anyone had their horse MRI'd for lameness? Feedback please?

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bgray1981

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Hi,

I took my lame horse to the vets the end of May for further investigations where he was nerve blocked and x-rayed. The x-rays showed nothing up and the vets diagnosed bilateral soft tissue damage.

I have tried giving him 6 weeks box rest and at the end of that when the vets came to re-examine him, he was still lame. The vet has suggested taking him for an MRI, but unfortunately my horse wasn't insured so we're looking at approx. £1000 for this. So for the time being the vets have suggested turning him away for 6 months and seeing whether he's still lame after that.

I would like to know if anyone has had their horses MRI scanned and what their opinions is of it, Also I'm thinking of getting a second opinion so if anyone could recommend a lameness specialist that would be helpful.

I look forward to hearing from you.
 
I had my Mare MRI'ed in Sept 2013 following weeks of mysterious lameness, no heat no swelling.
Nerve blocks showed us where it was, but not 'what'.
Bruising and everything else was ruled out - leaving us ligaments or tendons.
MRI revealed Lesions on the DDFT - Recommended was a course of steroid injections (which didnt work for more than 2 months) - Then it was a case of a year off anyway!
She is now in the field having a great time!!

I think the MRI lets the vets know whats going on to minute detail, it will help them assess whats going on and recommend treatment from there - Until they have the MRI it can be quite a bit of 'educated guessing'.

Good luck
 
As they think it's a soft tissue injury have they not done an ultra sound? If not this would be my next step and if it shows nothing then an mri might be the only way to go.

My mare had an mri done on her foot last year as she had a pedal bone infection and they wanted to rule out anything else sinister going on, the foot was clear but she was scanned on that leg and it showed a ddft injury in the back of her pastern area and they also did an mri on that to get a better look at the extent of the damage but that one was free which is why I agreed to it.

Also forgot to ask what part of the leg did he block to?
 
Vets just nerve blocked the fetlock. They also didn't suggest the ultra sound. I was thinking of getting thermal imaging done as this is a cheaper option before going down the mri route.
 
Mine was MRI'd nearly 2 months ago. Xrays showed nothing. MRI's took 5 hours! but they had fixed the charge at £970 all in. They showed severe collateral ligament damage to both feet (only lame on one of them) however after another month off he is now lame on the other limb. It was worth it for me as I'm not sure any other tool would have provided the same level of detail..... Currently going down the remedial shoeing route but he will only ever be a very steady happy hacker now. Good luck!
 
Thermal imaging can help locate where the problem but still needs to be followed up with further diagnostics to see exactly what the problem is. However with a nerve block to the foot you already know where the problem is.

You can't ultrasound inside the hoof capsule and x rays can reveal or rule out bone problems so you're back to an MRI.

What I would ask the vet is what would be the difference to the treatment plan if you know exactly which structures are involved? There are various ligaments or tendons it could be but doesn't necessarily change the approach.
 
If he has only blocked to the fetlock then I would want more blocks done to find out what area exactly is causing the problem, I had one block to the foot, further blocks were done to rule out various parts, it was xrayed and nothing showed so the next step was to MRI if we wanted to find the true cause of the problem, we decided to rest and then go for MRI if he did not improve within a month, which he did so the "diagnosis" of deep bruising was probably correct.

Ultra sound will not work if it is in the foot but will if above the hoof so nerve blocks should be used to pinpoint the area, MRI only does a tiny area, the size of the foot, so it is only appropriate if the nerve blocks have been done before referral otherwise you will potentially get an extra bill for doing them at the hospital.

Thermal imaging at this stage, when you know that the issue is below the fetlock, would be a waste of money, it is useful when you are unsure where the problem is but otherwise can show very little and will not give you a diagnosis of what the problem is, I would spend the money on some more blocks.
 
Ok, so I'm now getting the jist that the thermal imaging would be a waste of money. The diagnosis the vets given is bilateral soft tissue injury in the heels of both fore feet. I also forgot to mention that my farrier has changed his shoes to bar shoes, but I gather that's only a temporary measure.
 
So when you say heals is this the heals of his hooves or above? As the others have said if it's not the foot you can ultra sound, where the bar shoes put on after or before the lameness? They will usually block again before an mri is done anyway just to be sure they do the right bit if it's some time after the first blocks.
 
I believe above his hooves and the bar shoes were put on after the x-ray session at the vets so after the lameness occurred.
 
Weve just had mri and as well as finding what was causing lameness ended up with list of 16 bilateral items in each hoof. (Non of which caused any probs)

Think most issues either diagnosed with mri orp not end up with eithet box rest or turm away
 
bgray1981 said:
I believe above his hooves and the bar shoes were put on after the x-ray session at the vets so after the lameness occurred.
Click to expand...

If the vet thinks the damage is not in the foot I would ask why they have not opted for an ultra sound before doing an mri as this is the cheapest option as your not insured , then take it from there and see what they say, did the vet not explain why they wanted bar shoes on?

You mention having a second opinion where are you in the country?
 
You can't MRI much above the hooves without a General Anaesthetic which I'd think is even more expensive than the £1000? I think things are getting confused somewhere along the line either at the vets end or the interpretation of them.
 
My horse was diagnosed with bi-lateral forelimb lameness nerve blocking to the caudal hoof in November last year (mild between 1 and 2/10 lame). Both feet x-rayed with nothing untoward see. He was not insured. Sounds very like the diagnosis and situation you are in.

Vet advised ultra-sound unlikely to show cause of lameness as most structures are within the hoof wall so not visible and advised MRI scan to pin point exact cause.

I questioned whether pin pointing exact cause would change the treatment plan and the reply was no so I refused the MRI. Horse was shod in 'normal' shoes at this time. I was sent away with advice to shoe with heart bars for 2-3 cycles, field rest during first shoeing cycle then gradual re-introduction to light work for next cycle and re-assess as I went along.

I had every intention of following vet advice to the letter however my farrier was unable to attend for a week during which time I noticed my horse was standing much more comfortably on his front feet which were unshod after the shoes had ben removed for x-rays. So I did a LOT of research online and found some interesting studies of success rates and longevity in 'navicular type' horses which had either been remedially shod (35% long term sound) or barefoot rehabbed (85% long term sound after 5 years in the same or higher level of work). The sample sizes are small but these statistics were convincing enough for me to decide to try barefoot, I spent all winter researching barefoot management and walking my boy first in hand and then under saddle. Very happy to say he is now back at the level of work he was pre-lameness (25km pleasure rides) and though its early days but Im hopeful it will continue.

My advice OP is to question your vet closely as to whether or not an MRI and exact diagnosis is likely to change the treatment plan. Different if your horse was insured for loss of use then perhaps the extent of the injury would be better of being diagnosed precisely but that's not the case but you could just be spending a lot of money for information that is not likely to assist you much.

Whether or not you go down the BF rehab route is a purely personal choice. To do it properly and therefore successfully is a heck of a lot of hard work and at times a complete PITA! But I do credit it for giving me a sound (at the moment!) horse back. I wouldn't dare put shoes back on, much as I would like to, because I think he would end up lame again sooner or later. Good luck what ever you choose to do I know just how pants it is to be in your situation.
 
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Pinkvboots said:
If the vet thinks the damage is not in the foot I would ask why they have not opted for an ultra sound before doing an mri as this is the cheapest option as your not insured , then take it from there and see what they say, did the vet not explain why they wanted bar shoes on?

You mention having a second opinion where are you in the country?
Click to expand...

I am in Buckinghamshire
 
Pinkvboots said:
If the vet thinks the damage is not in the foot I would ask why they have not opted for an ultra sound before doing an mri as this is the cheapest option as your not insured , then take it from there and see what they say, did the vet not explain why they wanted bar shoes on?

You mention having a second opinion where are you in the country?
Click to expand...

The vet suggested bar shoes to give his heels some extra support, but that's pretty much all he said. He did talk to my farrier about it though.
 
I'm in a similar position to you. My horse is not insured and is currently lame on his off hind and has fluid in his pastern. He had a scan but it didn't reveal any tendon damage so it is possibly the DDFT below the hoof that is the problem as he went sound when the tendon sheath was nerve blocked. He is having a steroid injection into it tomorrow but if it doesn't work then an MRI would be the next logical step. I asked what would happen if we didn't MRI and he said they could go straight to an operation to look inside which is what they would do if the MRI showed up damage in the DDFT in the foot.
 
If vet has only blocked fetlock I would want him to start with blocking the back half of the foot first. And give you an assessment of the horse's hoof balance.

Also ask him what the treatment plan will be if you don't MRI/If you do.

I didn't MRI despite having a slightly woolly diagnosis as we knew it nerve blocked to the hoof (we had also blocked the coffin joint successfully) and his feet had under run heels - so the plan was rest and to steroid inject the joint and improve his heels in bar shoes. It wouldn't have been any different post MRI.
As it was it didn't work and I took his shoes off and he came sound.

claracanter I think yours is a bit different as you do have obvious swelling above the hoof.
 
Mine was MRI'd for mild bi-lateral lameness on front last year after x-rays showed mild arthritic changes and joint injections didn't work quite as well as we had hoped.

MRI showed mild athritic changes in the coffin joint, mild navicular and tiny tendon tear on his worse foot (even tiny by MRI standards according to the vet). She advised me that this could be perfectly normal for a 14 year old horse and the lameness could be caused by all, one or none of these things. When I took him back for further investigation she couldn't find the original lameness (although he was sore due to having his shoes pulled). She told me to bring him back into work slowly and see what happens. He never obviously showed any signs of the lameness and certainly didnt get worse.

So, I now have no insurance on either leg for any sign of clinical lameness, and no idea what was actually going on. Not overly helpful, but it is what it is.
 
I had mine done. Didn't show a great deal on the one hand according to the person looking at the images but on the other didn't show anything horrific that would have changed our treatment approach. The gold standard for imaging soft tissue (especially around the feet where ultrasound scanning just isn't really possible). If you think knowing exactly what's going on may change your approach then yes go for it. If your plan will remain the same regardless then if uninsured and having to count the pennies I probably wouldn't go for it unless curious. If the problem is above the foot then ultrasound may be worth a shot as it's a lot cheaper than MRI and will give you better answers than thermal imaging and should be possible in this area
 
My horse went lame back in April vet came out X-rayed and nerve blocked etc which showed nothing and he said he was 99% sure it was collateral ligament damage. He referred me for an MRI which straight away showed it was in fact a lesion in his DDFT and he has since had surgery.
I am glad i got the MRI done instead of just box resting him and hoping for the best however had he not been insured i could not have afforded to go down this rout and TBH 6 weeks after surgery he hasnt improved so im not sure if it has improved the situation that much.
Good luck with yours though.
 
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