Arthritis without lameness, what to do?

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ycbm

ycbm

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I wasn't going to share my experiences with Charlie with the forum but both in the interests of openness about taking on ex racers and because the forum has been so helpful in the past, I have decided to.

After six months, Charlie has never been more forward or joyful to ride. Something "unlocked" in him a little while back and his whole movement has changed. But a month ago I was worried about his left fore fetlock that was filling slightly. In spite of there being no lameness at all, including when I did a flexion test on him, I decided on some x rays.

Even the vet could barely make him lame with a flexion, and it took a 5m circle to show up with a minor head nod on hard ground. The vet was not expecting to see anything on x ray. And was therefore shocked to see extensive arthritis secondary to a "very old" sesamoid bone fracture.

He was injected with steroids to get the inflammation out of the joint, with the objective being to inject arthramid just before Christmas.

But now I'm wavering. He wasn't and still isn't unsound in normal work. I'm sure about this. Unilateral foreleg lameness is very difficult to miss and the other leg is clean on x ray. Part of me wonders why we would mess any more with the joint when he's sound. Part of me wants a guarantee, (given that the condition is pre-existing (can't morally be claimed on insurance even if we could blag it) and the arthritis is extensive, and arthramid will cost at least £500), that it will keep him sound for a good long time. Part of me thinks he's clearly on borrowed time as an 8 year old (Jan 1st) with a knackered joint and we should just give him bute when he seems stiff (which is not at all currently) and keep him going as long as possible with strategic use of bute.

I really don't know what to do. Ideas and experiences with both arthramid and arthritis without lameness?
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Interesting dilemma, I get why you're wavering.

My question is what are you hoping to achieve with medicating the joint if the horse is already sound?
Is it the leg filling that is the issue. Or that the xrays have shown more than expected?

My usual approach would be as conservative as possible. So I'd be inclined to ask for a nerve block just to try and have some reassurance that he's not being a hero and is genuinely unbothered by it.
If that's the case I'd rather avoid the risk of injecting joints on a functionally sound horse, and save the treatment for if it becomes necessary in future.
 
In this situation I feel the horse hasn’t read his x rays and would carry on as normal unless something changed in the horse. I would just make more effort round day to day management instead with turnout, long slow warm ups, manage weight and minimal holiday/completely off work. I would maybe increase glucosamine, chondroitin and MSM for the time being. I also hate myself for saying this but Turmeric is an anti inflammatory. Flax/linseed might be another thought due to the Omegas. I would work on moderation so you have more arsenal if needed.
 
LEC said:
In this situation I feel the horse hasn’t read his x rays and would carry on as normal unless something changed in the horse.
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This!
Expressed in a much more eloquent way than I managed 🙈
Also you know your horse, and are clearly very thorough. So would be able to quickly and easily identify any changes that might warrant further intervention.
 
My experience of arthramid wasn't great. The effects didn't last long, and when the vet x-rayed again (hocks) she said that in retrospect the arthritis had closed up the space between the bones too much for the arthramid to create a cushion. She recommended steroid injections as they have a painkilling effect, and my mare has been fairly good ever since. So before you go ahead I'd ask some questions about how much space there is between the bones.
 
I too would be loathed to do anything more invasive without it seeming to be needed at this time. Suggestion above re: nerve blocking to make sure there’s no pain there seems a good idea, along with supplements suggestions. On the plus side, you have x rays which might be useful for comparison in the future.

I’m not sure what level of work you want/ wanted him for. Is there any reason to suggest this would need to change any time soon?
 
LEC said:
In this situation I feel the horse hasn’t read his x rays and would carry on as normal unless something changed in the horse. I would just make more effort round day to day management instead with turnout, long slow warm ups, manage weight and minimal holiday/completely off work. I would maybe increase glucosamine, chondroitin and MSM for the time being. I also hate myself for saying this but Turmeric is an anti inflammatory. Flax/linseed might be another thought due to the Omegas. I would work on moderation so you have more arsenal if needed.
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I agree with this. It won’t hurt to give him some joint support, but I think I’d want to have something ‘in reserve’ for if/when it does bother him. He clearly isn’t needing that yet.
 
Tricky. Beau injured a hind jumping the stream in his field one day and he had steroids injected straight into the joint which was a huge help for years. Ultimately, he was on danilon for his last few years and non ridden, but he was a big lad. While he seemed comfortable and with the vet who knew him best saying he was fine as a field ornament, with occasional mad hoons around the field, he did deteriorate and was not a youngster.

Given Charlie’s age, I’d be trying anything I could in your position, but keeping a very close eye.
 
She's as far from a racehorse as you can get but the microcob went in for a workup Jan 22 after running into a fence and the vets went overboard with x-rays. We've got kissing spine in 2 places with wonky legs & wonky feet leading to thickened ligaments and early signs of hock arthritis. Once the check ligament she'd tweaked had healed I was preparing for retirement.

Pony has other ideas. She's maintained on bozmerix which seems to suit her and if we've had a particularly fast ride (usually her decision) then she gets a dose of devil's claw in her feed. Vet suggested that to ward off post ride soreness rather than riding her on it and her over stretching herself.

I'd just ride the horse you have in front of you and see how he goes rather than rushing through to injections.
 
If it could help preserve what's left of the joint, then I'd do it. If it's actually proven to have benefits as a proactive method.

OH had a horse ages ago with terrible x-rays. He did medicate hocks since the horse would usually show some symptoms if not injected at the right interval, but never messed with the atrocious front leg. Again, the horse didn't read his own x-rays, so they only messed with what actually bothered him (a type that would let you know what bothers him!).
 
ycbm said:
I Part of me wants a guarantee, (given that the condition is pre-existing (can't morally be claimed on insurance even if we could blag it) and the arthritis is extensive, and arthramid will cost at least £500), that it will keep him sound for a good long time.
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This old chestnut again. It's nothing to do with morally claiming it or even blagging it. If the horse was sound on purchase or passed a vetting then is either not sound or changes are discovered now at a later date, whether it's a week, a month or in your case 6 months it's not wrong to claim.

If you have health insurance, say on bupa and the doctor says " well Mrs YCBM, you are clearly in need of a hip replacement" are you going to say " oh I can't because it's a pre existing condition?" Did you know it was there before you took out insurance??

The insurance was taken out on the risks known and assessed at the time and the information the vet was able to gather at time of vetting. To insinuate that people are wrong for claiming for arthritic conditions is crazy, you would end up accusing half the country of pulling a fast one if that were the case.

In fact Pet Plans most common veterinary claim ahead of colic and laminitis is for arthritic treatment.

I have to say it did irk and upset me somewhat when you openly accused me and my vet on this very forum of ( can't remember the exact wording) basically deceiving the insurance company in respect of Lari when i claimed for arthritis. Totally unfair when the horse passed a five stage vetting weeks before and I had no suspicion of this!!I'm not trying to get in an argument with you but for all the hundreds, nay thousands of people on this forum that have claimed for arthritic conditions for our horses, you accuse one, you accuse all. ☹️
 
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My old cob mare had bad (as on x-ray) ring bone in her front legs found incidentally for something else. Was told the ring bone would probably finish her off before the injury we were x-raying for would. 15 years after that (when she did pass away from cushings) she never took a lame step from it so there you go 🤷‍♀️.

If he is sound and happy I would leave as is and treat conservatively accordingly if needed.
 
I had an old horse with arthritis in his fetlock that by this point id had him15 years so knew things werent quite right plus there were visible changes
I jabbed with arthramid.
1st jab...amazing
2nd time...wasn't sure if it had made enough of a difference
3rd time...I was convinced little to no difference so i maintained on bute

I think maybe for peace of mind it helped me that I tried to arthramid first.
 
I do think I'd probably be a bit more aware of ground I was working on...
So I think.with the info you now have I wouldn't jump on hard ground etc etc
 
Birker2020 said:
This old chestnut again. It's nothing to do with morally claiming it or even blagging it. If the horse was sound on purchase or passed a vetting then is either not sound or changes are discovered now at a later date, whether it's a week, a month or in your case 6 months it's not wrong to claim.

If you have health insurance, say on bupa and the doctor says " well Mrs YCBM, you are clearly in need of a hip replacement" are you going to say " oh I can't because it's a pre existing condition?" Did you know it was there before you took out insurance??

The insurance was taken out on the risks known and assessed at the time and the information the vet was able to gather at time of vetting. To insinuate that people are wrong for claiming for arthritic conditions is crazy, you would end up accusing half the country of pulling a fast one if that were the case.

In fact Pet Plans most common veterinary claim ahead of colic and laminitis is for arthritic treatment.
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I'm not interested in arguing with you about the morality of claiming for a clearly pre existing condition on a previously out of work horse owned 6 months which my vet has told me was caused by an old and very visible sesamoid bone fracture .

We have enough threads about the exorbitant cost of insurance for me to know what my position on this is.

If you can help with the actual issue, please do. Meanwhile I would be grateful if you stop accusing me of insinuating anything. What other people claim for is up to them. This thread is about me and my horse.
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I personally think I would use the information to my advantage and work with that knowledge...ground conditions, supplements or whatever you choose.

I'm a great believer in seek and yee shall find.

I reckon most if not all of horses will have something somewhere...some owners are blissfully ignorant. You just know about yours
 
ycbm said:
I'm not interested in arguing with youabout the morality of claiming for a clearly pre existing condition on a previously out of work horse owned 6 months which my vet has told me was caused by an old sesamoid bone fracture .

We have enough threads about the exorbitant cost of insurance for me to know what my position on this is.

If you can help with the actual issue, please do. Meanwhile I would be grateful if you stop accusing me of insinuating anything. What other people claim for is up to them. This thread is about me and my horse.
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Well I don't think it was fair for you to have said what you did at the time and your comments didn't help me either at the time. Tell me how then it's the number one condition claimed for on insurance that all horses don’t fall into the 'pre existing catergory'?? Because they obviously don't

FWIW I wouldn't do anything proactive at this moment in time in terms of medicating Charlie. My own positive experience of arthramid was short lived. Although it seemed to help Baileys coffin joint arthritis initially it ended up having a negative effect for her because free from pain she carried herself differently and overcompensated in such a way that caused more weight in her heel and caused her issues which sadly resulted in her euthanasia. That was my own personal take on it.

I always say if it ain't broke don't fix it. I wish I'd never been swayed by my vets to try it. If I'm in a similar position again I think I'd ask more questions.
 
Tricky one… Is your vet thinking the arthramid will genuinely help protect the joint from further damage? If so definitely worth considering doing it but it’s not without risk and can see the argument for not rocking the boat as well.

I’m going to turn into a broken record on this as we’ve just got one at work and genuinely impressed with it but if you decided against the arthramid but you have access to a vet or physio with a class 4 laser it may be something that might help with the current symptoms of the swelling with less risk than joint injections. Will admit we’ve not specifically used it much for arthritis yet (we’re planning on starting now we’ve got our own machine) but have seen good results on other things we’ve tried it for. Think you could either use short term to help with current issue or as a long term maintenance type thing.
 
Boulty said:
Is your vet thinking the arthramid will genuinely help protect the joint from further damage? If so definitely worth considering doing it but it’s not without risk and can see the argument for not rocking the boat as well
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That would be my question. I don't know enough about Arthramid and how it to comment but if something could help prevent previous deterioration and keep you at the point you are now I'd consider it as a preventative. If it's about alleviating pain or increasing mobility, then that's not what you need now as that doesn't seem to be an issue.
 
I’m sorry to hear about this.

As you probably know, I’m a fan of Arthramid which I have used to great success on two of my horses (hocks and front coffins on one, and hocks on the other). They were both lame, though.

It is a genuinely therapeutic intervention which does help to preserve and enhance the joint lubrication, it has no direct analgesic effect like steroids do, it’s a mechanical effect. My wonky mare had her hocks re done early this year 2.5 years after her first Arthramid jab (this time Arthramid + steroids at the same time, which my vets recommend), and it’s worked brilliantly. Her hocks are very nearly fused, and there was hardly any space left to get the needle in, but still it’s worked.

What would I do with a horse that is still sound? I would have a discussion with my two very trusted vets, ie my regular vet and my chiro vet, and ask their opinion on what would be best to do. Either of those would give completely unbiased advice on whether or not Arthramid might be beneficial. They have access to more literature than a lay person.

There are always risks when medicating a joint, but when well done with aseptic procedures and meticulous disinfecting of the injection site beforehand, they are low.

I would be minded to go for Arthramid unless my trusted vets advised me that the risks would outweigh the benefits in this case.

Good luck.
 
ycbm, I know a TB who is built very similar to your Charlie (also a bay TB!). He had an extensive racing career and evented up to 1*/training 2*. He has always had, since the age of about 4, an ugly looking knee.
It was x-rayed by a vet out of interest when he was about 12, x-rays were ugly but the horse was sound and the vet said leave it be until it started causing issues. He continued eventing until the age of about 15 when he started refusing and was retired to hacking. He is just now showing slightly unlevel in that leg warming up at the age of 18 (probably not obvious to people who don't know the horse), but movement helps and he is packing around a 12 year old beginner happily (lives out 24/7 which helps too). He has not needed medicating so far for this.

The knee isn't as high impact/movement as the fetlock so not a direct comparison, but a case of "ride the horse, not the x-rays". Any more comments on the sesamoid fracture? Near any ligament attachment points?
I have dealt with fetlock arthritis before and would be tempted to go ahead with the arthramid injection and keep him moving with an eye on the ground you ride him on. Like you, I noticed a slight swelling in my mares fetlock without lameness, but the vet at the time dismissed it as windgalls and I firmly believe if I had intervened earlier, she would not have ended up lame with limited options two years down the track.

I imagine you weren't aiming for him to be a high level jumper or eventer, so that path may not differ so much to what you would do anyway.
 
We injected Millie with arthramid. She has very slight changes found in her patterns and one hock and then more substantial changes in the other hock.
She was just very behind the leg and unwilling to go forwards, but never naughty or anything.
That was July 2022 and we’ve not had to re do the arthramid yet, she’s still doing really well.
 
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