best case scenario for bilateral lameness?

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amycamycamyc

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I have a rising 5 year old who is bilaterally lame in front,been to RVC for full work up, found to be sound on the straight/soft but crippled lame on a hard circle. was nerve blocked and found source of lameness is in the heels. X-rays looked pretty good - some v minor changes in navicular bone but RVC vet thought insignificant. Recommended I take him home, box rest for two weeks then try to bring back into work... we didn't make it that far. I had my normal vet trot him up after two weeks and if anything he looks worse!
Hopefully going back in to the college for MRI/bone scans now.

Anyway I'm no vet, and of course I have been scaring the life out of myself reading about all the possible things this could be. Was hoping somebody out there might be able to give me a ray of hope!! Is there anything simple, fixable, painless, quick (cheap!) that this could be, or is the outlook really as bleak as it feels.....he's only a baby!
 
I spent thousands on vets bills with same problem mine had every investigation and treatment money could buy.In the end I retired him as 7 yr old and put him to pasture as companion.The new owner promised me she would give him year off as he was paddock sound took off his shoes and he has now returned to work.He had low heels and has balanced his own feet with help of good farrier.I spent mega bucks on remidial farriery and treatment at the end of the day he need extensive time off to recover.
He had hock spavin collapsed heels and soft tissue damage.After 3 years and loads of heartbreak I decided that companion was his best option.He is now very happy and healthy time is greatest healer.If you can turn away it might be all he needs.Mine was messed up as young sprinter too much too young.
 
Thanks Cellie, I'm mentally geared up for turning him away if needs be, was hoping for six months rather than a year though(!). Great to here yours has come sound in the end :-)
 
Bilateral lameness on hard ground on circles and not on soft ground or on the straight, nerve blocked to originating in the heels? You are pretty sure to end up with a diagnosis of navicular syndrome or ddft injury within the foot. You'll be offered Tildren, Adequan, bar shoes, hyaluronic acid. If you take his shoes off and learn how to manage him barefoot you will probably need none of those things and he could be sound in weeks, especially as he is so young and the disease recognised so early.

My rehab horse, off to a new home next week, had all those treatments and was still lame. He's twice the age of your boy. And he was sound in the tenth week, well placed in dressage competition in the eleventh week, did a 6 miles farm ride and jumped in the twelfth week and has not has a days unsoundness since. If you are interested in this route, start by looking at rockleyfarm.co.uk and follow every link you find to research barefoot. It's not necessarily easy, some of them can't manage stony surfaces without some serious adjustment and management of their diet (my rehab can't have any grass, for example, but he's a severe case) and you would need to commit to getting that right. And if your vet and farrier are ill-informed or positively anti a barefoot approach you will find it a lonely and very stressful journey to go against "the experts".

There is huge hope for your baby, there are now many, many examples of written off navicular horses back in full work with no shoes on. Many of them, like mine, were write offs.
 
Just read the previous post and I doubt if it was the time off that did the trick, but the fact that his shoes were taken off while he was turned away.

None of Rockley Farm's rehabs (a commercial rehab yard) are taken out of work, and neither was mine or any of the others that I know of. In fact controlled work is very beneficial to growing a good hoof and the lack of work quite possibly delayed the recovery of the previous poster's horse, rather than being the cause of it.
 
thanks cptrayes - have no idea what the yard politics about barefoot would be like, but i am loathed to go down the multiple treatment routes. Seem to hear too many stories like cellie's where they try everything (at great expense) to no avail.
The problem with keeping mine in work is the "controlled" bit! although i think his misbehaviour is related to the pain so presumably it would go once he is happy in his feet again.

right... off to the rockley farm website....
 
Mine was similar, nothing on Xrays but nerved blocked lame to the back of the foot.
I had an MRI done and that showed mild damage to the DDFT, DSIL and Collateral ligaments.

He had loads of box rest and really careful slow bringing back into work but never stayed sound with either work or turnout.

As a last resort he went down to Rockley farm to rehabbed barefoot and is doing really well, he is in more work than he's been in for a long time and I'm getting him back in 2 weeks time. It's fantastic to be able to have a proper gallop on him and next step jumping.

Incidentally I recently found some photos i took when he was on box rest/remedial shoeing so I could check his progress. What they actually show is far from improving, his feet were getting worse and worse.

What part of London are you? if it's not too far you could come and visit me and Frankie when he gets back
 
cptrayes said:
Just read the previous post and I doubt if it was the time off that did the trick, but the fact that his shoes were taken off while he was turned away.

None of Rockley Farm's rehabs (a commercial rehab yard) are taken out of work, and neither was mine or any of the others that I know of. In fact controlled work is very beneficial to growing a good hoof and the lack of work quite possibly delayed the recovery of the previous poster's horse, rather than being the cause of it.
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I couldnt quote whole story to lengthy but vet advised bringing back into work after all treatments £11000 worth:eek: all 6 week rehab walk trot canter but he never improved to the stage were he was comfortable and I felt he was in constant pain even though vet didnt agree.At the end of the day we know our horses and their reactions.I feel he had extensive concussion and collateral ligament damage.I tried rehab on and off for 3 years so can honestly say it wasnt lack off work I did everything the vet instructed.I realise you didnt have full picture but feel work delayed healing process for my horse.I suppose they are all individual what works for some doesnt work for others but Im so pleased I didnt pts which was recommended by others he has great quality of life now and time was what he really needed.
 
My horse sounded similar to yours, sound in a straight line but 5/10 lame on a hard circle bilaterally in front, so pretty lame. Had full lameness investigation including MRI and was diagnosed with navicular oedema. He had tildren and remedial shoeing for one set and was then turned out for 12 weeks - with regular front shoes on. Brought him back into work slowly, 6 weeks walk, 6 weeks trotting etc... He has now been sound and eventing (BE100) for the past two seasons so they can come right.

Not necessarily the cheapest option but if the horse is insured then I would stick with the plan of having an MRI just to be sure of exactly what is going on with those front feet.
 
Absolutely yes to MRI as the others have said, that is the only way you can see the soft tissue damage if it exists. And absolutely yes to work BUT only good work is good work, and that is where the experienced people who have successfully rehabbed horses with caudal hoof pain barefoot have the knowledge to do what is best for each individual horse. My horse is in the early stage of rehab, so I won't make any claims at this stage, other than to say he is far happier and comfortable and better behaved than he has been for a long time (ever?) .

If you go down this route you just have to take the time it takes, and appreciate that this may not be the only injury your horse has as SOMETHING has caused this problem. Every horse's situation is different and you cannot put a time frame on it. I'm sure, as we've all discussed this before!, that both cptrayes and criso will agree that with their horses this is still the beginning, and there is plenty more work ahead to be able to improve their horses' fitness and manage their conditions in the future. Once you've started this journey it's all-consuming but hopefully very rewarding!
Good luck.
 
cellie said:
I couldnt quote whole story to lengthy but vet advised bringing back into work after all treatments £11000 worth:eek: all 6 week rehab walk trot canter but he never improved to the stage were he was comfortable and I felt he was in constant pain even though vet didnt agree.At the end of the day we know our horses and their reactions.I feel he had extensive concussion and collateral ligament damage.I tried rehab on and off for 3 years so can honestly say it wasnt lack off work I did everything the vet instructed.I realise you didnt have full picture but feel work delayed healing process for my horse.I suppose they are all individual what works for some doesnt work for others but Im so pleased I didnt pts which was recommended by others he has great quality of life now and time was what he really needed.
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Cellie you obviously had a very damaged horse and you have obvisouly done the right thing for him. For other people, though, my reference to work meant work with no shoes on. If the horse being treated works with shoes on and it was the shoes that caused the damage, then more work in shoes wouldn't help. The work works (:)) when you have got a heel first landing, and that's not something you'd see in a horse with heel pain in shoes.
 
To answer Stormybracken's point that there is "plenty more work ahead", I don't expect to do any more work to resolve my rehab's navicular syndrome. I have no idea if his xrays look better, but he is galloping around a very sloping and bumpy field, jumping, hacking, schooling on tight circles, can be circled tight on tarmac and has no lameness issues at all. He's not even stiff after standing all night. His diet is another matter, largely unrelated to the navicular syndrome. He is effectively a type 2 diabetic, in human terms. But as long as we manage his diet very tightly, his feet are good and strong. I am advising his new carers to treat him as if he did not have any issues with navicular syndrome, because he doesn't, and I have invited them to come hunting with me in the new season if we can crack his last bit of sensitivity to stones so he can go without boots.

He's not unique in his progress by any means, nor am I some miracle-worker with expensive facilities or supernatural skills or years of training. The commercial rehab yard already mentioned frequently sends horses home jumping and galloping after about three months (not every horse, but a good proportion). One they sent home went hunting on Exmoor on its last day there, and a current one featured on rockleyfarm.blogspot.com can be seen cantering around on far from perfect going.
 
In Frankie's case the back of his foot is very weak, his background and upbringing means it is very underdeveloped and while is it much better than it was there is still some way to go till he gets the best possible foot he can. He doesn't at this stage appear to have any particular diet issues though I've always based his diet on forage and avoided sugar due to not wanting to ride the "amazing airbourne TB" he turns into if I feed him heavily molassed chaff.

Meanwhile yes he is capable of fast work and 8 mile hacks and we are going to start jumping him but in year's time say his feet will probably look even better so he is still a work in progress.

He was lame for 18 months before his shoes came off so for me 4 months in the grand scheme of things is not very long to give him a future he didn't have in February but someone else might perceive that as a long time.
 
Just a quick one and it might seem like a really silly idea...but i've just been through the same as you. Confirmed Navicular with X rays and given a 40/60 chance of being sound ever again and decided to go the barefoot route. Bearing in mind that he has been seen by the farrier on a regular basis and then the vet who took his shoes off-the first thing that my AEP (favourite person in the world ever) said was 'he has really bad whiteline disease' so we soaked his feet in Cleantrax and I swear he was sound the next day!

just a thought-everyone will think i'm mad but i was basically told to give up hope!

Take his shoes off and give him a chance.....
 
It does completely depend on what the MRI shows as it could be a number of things but the symptoms you describe hint towards soft tissue damage.
Success does vary from case to case although is improving all the time. Barefoot is definitely worth considering although it doesn't suit them all. Unfortunately I have a TB with collateral ligament damage who cannot go barefoot even with careful management. He did come sound following nine months box rest and returned to light dressage. Sadly he has a number of other issues and the collateral ligament exacerbated these problems meaning he had to retire. He's been a very happy field ornament for over a year now but two weeks ago we decided to bute him as he is no longer comfortable. I have had to accept we are reaching the point where I will have to make a difficult and heart breaking decision.
In terms of advice - Sue Dyson is the leading expert on this injury and conducted initial research into the injury seven years ago when it was only just known of (following MRI). Now it is far more common and hence vets are getting better at diagnosing and treating but prolonged rest is quite often key especially with those so young so be prepared for the long haul.
Good luck.
 
Marchtime please ignore this if you horse has already had a grass free and sugar free diet (I mean none, not "restricted") or his "other issues" override any caused by his diet.

Please don't give up on him yet. If by "careful management" you meant diet, and that you restricted your horse's grass/sugar intake very carefully, my rehab was the same. He was allowed only a "starvation" paddock, grasswise, and fed unmolassed beet, yet still he was about to be put to sleep with feet that would never have coped barefoot. It was only by removing him from grass totally, soaking his forage, feeding unmolassed beet with masses of oil and a high dose of vitamin E that I managed to get his feet to concave up and he is now going from strength to strength. You might not be able to offer your horse such a lifestyle (my fellow's owner couldn't, and I don't blame her - it isn't easy) but you might just find someone like me who is can do all the work that is entailed to see if it will work for him.

"prolonged rest" to resolve ddft/collateral ligament damage inside the foot appears to be necessary only if you rehabilitate the horse with shoes on. Barefoot rehabs work from day one unless they have some other problem too. Unless they are obviously lame in walk on a giving surface, they walk on a giving surface, in hand if necessary (I got fit, the horse came sound). And progress to more work on more difficult surfaces the sounder they get.
 
probably going to sound like a total numpty but with the comments about "absolutely no grass" it got me thinking... My boy was stabled 24/7 when i got him - he came from a jumping yard in the Netherlands. But with me I started turning him out slowly (on basically a mud pit to begin with in February, then slowly onto proper grass). Could this addition to his diet have caused the problem? He also seems to have got worse lameness wise on box rest when he was fed haylage instead of normal hay (as we had a batch of horrid hay he wouldn't eat)....
NB. He's fed carrots, calmer chaff and a token amount of speedi beet, twice a day as well as ad lib hay/lage.
 
It is so moving when these successes are reported - literally brings a tear to my eye. I remember sitting next to someone at a "barefoot" talk whose 10 year old mare had navicular and went through ALL the veterinary treatments - shoes, drugs, etc. but in the end was PTS. This poor lady was nearly in tears as the speaker described what was regarded as "conventional" treatment and what was the usual outcome as the feet deteriorate. The speaker then went on to outline what the "barefoot" treatment is, although he stressed that X rays and scans are vitally important or you may be trying to help a horse that is too badly damaged to be helped and beyond help.

Any responsible rehab yard would only work with proper diagnosis, scans, X rays etc. but the successes are amazing and wonderful.
 
It is so moving when these successes are reported - literally brings a tear to my eye. I remember sitting next to someone at a "barefoot" talk whose wonderful 10 year old mare had navicular and went through ALL the veterinary treatments - shoes, drugs, etc. but in the end was PTS. This poor lady was nearly in tears as the speaker described what was regarded as "conventional" treatment and what was the usual outcome as the feet deteriorate. She told me that what exactly happened toher horse, and to think that if only she had known she might have been able to save her. The speaker then went on to outline what the "barefoot" treatment is, although he stressed that X rays and scans are vitally important or you may be trying to treat a horse that is too badly damaged to be cured and beyond help.

Any responsible rehab yard would only work with proper diagnosis, scans, X rays etc. but the successes are amazing and wonderful.
 
I don't disagree that barefoot works for many horses but unfortunately he has too many other issues. His collateral ligament injury is caused by having pedal bones which are very low lying and at the incorrect angle. The vets opinion was he'd probably either been born this way or suffered some foot trauma as a very young foal but it would now be impossible to change the angle. Whilst barefoot could improve his foot balance because his pedal bones are so low he suffers extreme concussion and even with boots he struggles. When he was in work he always had gel pads which worked but now he's retired he's copes without quite happily.
I'd never take the decision to 'give up' lightly and but he's 12 this year and with a catalogue of problems (including PSD, sacroilliac and query hock issues) combined with the fact that he has always been far from an easy ride or easy to handle (not due pain I'd like to add, simply spirited shall we say!) I would never consider handing him over to someone else. He's with us for as long as we can keep him comfortable.
I'd also like to add that since retiring he has put on masses of condition and looks better than ever before. My physio can't believe he's still got such good muscle tone so I know that for him it was the right decision.
 
I think that if you were going to consider going barefoot its essential to speak to a qualified trimmer or equine podiatrist.
The pedal bone can actually change position given the chance. Like in laminitis, a dropped pedal bone can actually change to its correct position again with the correct treatment.
Obviously i cant say what the best treatment is as i dont know the case, but 12 years old is still very young. Horses live well into there 20s and even 30s, and foot problems are the most common causes of horses being pts young.
To correct something like this, it could take a very long time. you have to consider the best options. Whether to have him sound and happy in shoes, or take the time to allow his feet to recover. If you are going to retire him anyway, he really doesnt need shoes. You say that boots didnt work for him? Again, a trimmer or ep would be best to speak to because farriers i dont feet are equipped with the knowlage to help with the barefoot treatment. There are so many EP's in the UK if you google the EPAUK wepsite, you can find a local one.
 
amycamycamyc said:
probably going to sound like a total numpty but with the comments about "absolutely no grass" it got me thinking... My boy was stabled 24/7 when i got him - he came from a jumping yard in the Netherlands. But with me I started turning him out slowly (on basically a mud pit to begin with in February, then slowly onto proper grass). Could this addition to his diet have caused the problem? He also seems to have got worse lameness wise on box rest when he was fed haylage instead of normal hay (as we had a batch of horrid hay he wouldn't eat)....
NB. He's fed carrots, calmer chaff and a token amount of speedi beet, twice a day as well as ad lib hay/lage.
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If he has soft tissue damage then I would expect him to be more lame if he is not allowed to keep moving, so it might be that.

But if you have noticed a difference between hay and haylage in how sound he is then he sounds like he has a some food sensitivity. Perhaps your haylage is higher in sugar than your hay. My horse was similar, sound when shod and stabled 24/7 in Portugal. Carrots are a big no for horses like this, they can even bring them out in lumps. In a very sensitive horse, like the one I have, the sugar seems to act very quickly, 24 hours, and it seems to cause the laminae to swell and stretch and allow his pedal bone to sink inside his foot, so that overnight the level of concavity in his feet can go up or down depending on what he ate the day before.

I realise that this sounds ridiculous to sceptics, and to vets who tell people that the position of the pedal bone can't change, especially not in those time periods. But it can, and it does, and any owner of a barefoot and very sugar sensitive horse (basically a type 2 diabetic horse) has seen this reaction.

If the laminae are a bit swollen and stretched then presumably they also hurt. The sole certainly feels stones much worse, and the change in stability of the pedal bone probably makes the tendons hurt where they are damaged. I can easily see how he would appear "more navicular" because of a sugar reaction.

I can also see, as seemed to happen in my case, that introducing grass to him when he had possibly never eaten it in his life (they barn rear valuable youngsters on the continent) could have weakened his feet to a point where he could no longer tolerate shoes and it has caused problems inside the feet. I have xrays showing soles of just over 3mm thick (that's way too thin) from my horse when fed grass. They must be at least double that now, and I can no longer bend them with my fingers.

Can you try your fellow on hay soaked for 24 hours to get the sugar out and see how he goes?
 
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