Arthritis - Is it worth getting an MRI scan?

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bec81

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My 15 year old mare was diagnosed with arthritis in the coffin joints on both fore feet approx 2 1/2 months ago following nerve and joint blocks and x-rays. She had been intermittently lame in trot.
She had steriod injections into both joints and was put onto a glucosamine supplement.
She had a few days box rest, followed by 2 weeks field rest, was then ridden at walk for 2 weeks before reintroducing trot. After 1 week of trot work she was still not right (although better than before treatment started) so the vet came back out and we went back to walking for another 2 weeks. We have just started trotting again, and she is still not right, varying from day to day and even during a 30 minute ride.
Have spoken to the vet today who has suggested a few options, one of which is to have MRI scans done to see if there is something else going on in the foot. Not sure on the costs of this but I believe my insurance will only pay 50% of the costs and only if they have agreed in writing first.
Does anybody have any experience of struggling to get a horse sound again after this sort of diagnosis? and/or does anybody have any experience of MRI scans for this type of ailment? Is it worth the money?
Sorry for the long post, wanted to provide as much info as poss :)
 
MRI's are very expensive. On a programme I watched last night, a dog was MRI'd and it cost £1500.

Unless there is a real chance of finding something else going on, I wouldn't bother. Arthritic horses often need to keep moving and are better after a long, slow warm up. If possible keep them out and give it more time. It will be an on-going condition rather than a quick cure.
 
Thanks Faracat, knew they were expensive but didn't realise they were that much!
I appreciate that there is no quick fix, and that there is no cure, it's just about managing it.
She lives out 24/7 and am happy to take things as slow as she needs. At the end of the day I just want what's best for her, and if need be I will only ever walk her (she has always been completely sound in walk) or I will retire her and she will be pampered until the end of her days.
At the moment the vet thinks that working her "little and often" is the best thing for her, so I am riding her for 20-30 minutes daily with approx 2-3 minutes of trot, which I split up to a minute at most at a time so she is not trotting for long periods, depending on how lame/sound she seems - usually worse towards the end of the ride.
Just got concerned after speaking to the vet today as she said it's unusual for them to still be lame at this stage (following injections etc), but did say that I'm doing everything right and to just keep doing what I'm doing.
 
My mare was intermittently lame 3yrs ago, she didnt have arthritis. She had an MRI done and this confirmed a tear within her hoof to her DDFT, the scan was the only way to find this. My Insurer, NFU, paid 50% and it cost me £512 at the time, it may be a little more now. It was definitely worth it as it confirmed exactly what was going on with her and it gave us the plan for her recovery for sure.

Thought I would share this with you to show how useful the MRI scan is as a diagnostic tool, but it may not be appropriate in your case. Your Vet or indeed a second opinion, is the best way forward for you and your mare. Good luck with it and hope she recovers.
 
When mine was MRI'd for soft tissue injuries in the foot, it was pointed out on the report that MRIs are bad at showing arthritic changes, so if your vet wants one done it sounds like he wants to check for anything else going on in the foot.

I was with NFU too and paid about £500 which was half though they told me the other day now they pay the full amount.
 
My mare has arthritis in the coffin joint right fore, and ultrasounds have shown soft tissue injuries. She is going for MRIs to assess the extent of the damage. I do sort of wonder if there is any point having the MRIs, given that we already *know* that she has damage to the ligaments, but my insurance company (NFU) have said they will pay the full amount and I suppose this will allow us to see the extent of the injury. I don't know, it's tricky!

ETA if there is soft tissue damage in the hoof, I don't think working the horse is necessarily the best thing. I certainly wouldn't consider riding my mare atm.
 
I'm with NFU. I thought they only covered 50% but will have to check with them, hopefully they will pay the full amount.
The xrays showed definite changes to the bone, which confirmed my vet’s suspicion of arthritis. However, some of what's going on doesn't seem to fit in with the 'normal' arthritis sufferer - eg with arthritis they are usually worse at the beginning of a ride due to being stiff, but my mare is worse at the end of the ride. Also, with arthritis they are usually better when they are being consistently worked, but mine was better after having a week off (just after her second lot of walking work she had to be rested for a week after an incident with another horse). Makes me wonder if there's something else going on other than the arthritis.
Thanks for all your comments, giving me lots to think about
 
Frank (19) has djd (no changes on xray in one coffin joint, sound on nerve block) he was better after 3 months off than he had been in work. I worked on the assumption that given some foot imbalances and the less than optimal position of his pedal bone it was likely that he had some associated soft tissue damage. Much that it would have been lovely to know exactly what was going on it wouldn't have changed what I considered as treatment options. He was steroid injected and remedially shod but not sound.

Slow motion video of his lame foot (well and the others) has been very revealing with regards to his landing.. he was landing very laterally (has always dished) and made me think even more that he was likely to have at least some collateral ligament strain going on.

Shoes weren't helping and he was lame 7 weeks after the first injection, had a second steroid injection and shoes came off in April. Is still sound but still in light work currently. Feet have changed a lot in that time and I think are doing a much better job of supporting him and the joint (I can pm you some video if you would like). I figured if he wasn't sound enough for hacking with some trot he was retiring with shoes off anyway!
 
Thanks ester. It's been 10 weeks since the injections, the vet doesn't want to give her another one at the moment as she doesn't think it will help, but has said that she may give her another one after 6 months.
She's had remedial shoeing, her balance wasn't good and the farrier has copies of the x-rays to work from to try to get her more balanced, her feet do seem better since he has changed how she is shod. He hasn't suggested taking shoes off.

Would be interested to see videos.

I'm inclined to rest her but the vet says to keep working her.

I'm taking my mare up to my instructors yard on saturday so that she can have a look at her and give me a second opinion, as looking at her every day I'm starting to struggle, whereas my instructor hasn't seen her since the day she was nerve/joint blocked, so should be able to say whether or not there has been any improvement at all since she was diagnosed. Filming it seems a good idea, will have to try that.

Phoned the insurance company and have confirmed that if they agree to MRI then they will cover full cost, but still not sure if it's worth going down that road at the moment.
 
Frank's feet looked better after remedial shoeing (much better heels, farrier had xrays etc) but am not sure they were functionally better if that makes sense. My vet didn't suggest it, as although had success taking shoes off naviculars hadn't really tried it with coffin joint problems, it was my suggestion to give it a go and he supported it. The second injection was to sort of give him a head start with the barefoot as we knew it would bring him sound again and then I could try and maintain it.

I haven't found taking shoes off to necessarily be the cheap or easy option short term but am hopeful in a few months we might be fully functioning again. I am poss taking it slower than necessary but there is no real rush (and am v much a newbie to it!)

I just think that MRI is a lot of money for info that won't really make a difference.

If you do want to think about a shoes off approach useful places are:
http://rockleyfarm.blogspot.co.uk/ (it was nic who gave me a trimmer recommendation and put my mind at rest on a few things)
http://phoenixhorse.myfastforum.org

I think it is worth some thought anyway if the other approaches aren't really working satisfactorily.
 
I know what you mean, this is all new to me, and I've been taking things slow. My vet even commented that she can't believe how patient I'm being and was impressed by how slowly I'm taking things. Just starting to feel a little lost!
I'll give those sites a read, thanks for all the info :-)
 
you should have a pm, I think its best to familiarise yourself with the concept first to see what you think and if its a possibility for you, there are lots of very helpful people on here and on phoenix to try and make it easier.
 
My boy aged 15 has coffin joint arthritis in both front feet with the off being slightly worse than the near. He was diagnosed with moderate to severe arthritis. It settled in 2005 following a steroid injection into it and then in 2011 he had it injected again. His symptoms are that he is unlevel when first taken into trot in the school for about half a lap and then is sound. Then remains sound for the session but when stood to be untacked outside his stable on concrete and then turned to walk into his stable he can display some alarming pottery steps. If you were then to trot him up in hand on a concrete surface I would say 5 times out of ten he would be sound! The vet said I have two choices, either bung him out in the field and forget about him or ride him on bute as and when I felt he needed it. It seems to have settled down again at the minute whereas three weeks ago it was getting quite problematic to the point that I was considering having to put him on bute for a while. I don't have a problem with bute, its only like us taking a painkiller for our arthritis or a paracetamol for a headache. My vet is happy for me to continue using bute and dishing it out to me, and says "just take him out and enjoy him" referring to jumping and dressage comps.

I'd just go with the bute, maybe a bute trial. Can't really see the benefits of an MRI to tell you there is something else wrong with his foot when bute will sort it out anyway.

Just make sure you don't trot on the roads, and be careful with hard ground (ha ha - no hard ground at the moment!).
 
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My horse has coffin joint arthritis in his right fore. Steriod injections worked magic but over time became less and less effective. Eventually, I was hacking my horse quite successfully on one bute per day. Then some time later he managed to get collateral ligament damage in the same foot. With CLD my horse displayed unlevel steps on the outside of a circle on a lunge. Vet advised MRI scan to confirm diagnosis. Was referred to Royal Veterinary College for the MRI which did, indeed, confirm CLD. I was told that, unfortunately, the treatment for one condition was totally opposite for the other. CLD needs rest, arthritis needs movement. Was also told that steroid injections actively slow down the healing process of the ligaments. In the end the vet advised 3 months box rest. Was a TOTAL disaster because he came out of box rest worse than when he went in. Had never been lame in walk but after this box rest he was hobbling.
My advice, if you can afford it, get it confirmed via MRI - at least then you will know what you are dealing with. If not, then I think your best bet is to turn away for a few months in a field 24/7 and let nature do its best. At least then your horse will be moving and helping the arthritis. Riding your horse with some sort of soft tissue damage will only make things worse.
Hope things work out for you. Good luck.
 
Having had an MRI scan for my mare as already said, I would definitely go for it if your Ins Co are willing to foot the bill. Takes away all the guesswork of "is there something else going on?" and gives you a better definitive plan for future recovery.. Would also add that its a fascinating experience, I was there whilst it was done.
 
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