Bizarre vet visit .....

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Dougal9

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So for various reasons far too long to go into, I had a vet come out yesterday as a second opinion on my horse's lameness in his right hock. Same practice just different vet. We obviously went through the usual chit chat about horse's background etc whilst stood at his stable with him poking his head out wanting a fuss. So he yawned a couple of times - maybe 6 at most and my vet asked if he did this often - no was the reply from me. Vet then went on to say that yawning could be a sign of liver disease and before I knew it whipped out a needle and took a blood sample for him to send away and check - he then said he would also use some of the blood for cushings test as it was free until end of October. My boy has absolutely no symptoms of either liver or cushings issues - my worry (apart from vets competence) is that now these bloods have been taken they will be on his record and affect any future claims as far as insurance is concerned regarding anything to do with liver function or cushings ?
Needless to say, both vet and practice are now ex vet practice. Despite all of us on my yard being able to see that he is lame this vet wanted him put on a fast walk on the walker and lunged on a 5m circle for the next two weeks to see if he gets worse !! My boy is currently still being treated for ulcers with gastrogard and as I had nearly run out I asked him to bring some more - when I asked him about alternatives he very kindly told me that he gets paid more for selling gastrogard to me. He was with us for an hour and three quarters. I'm about to call the practice to complain about the visit and tell them that I'm not prepared to pay for it.
Anyone ever heard of yawning being a sign of liver disease ?
 
yes when it is happening a lot yawning can be a symptom of it. but just because the horse yawns x times it does not mean that it has a liver problem if that makes sense.
 
But having a horse with a liver problem currently if someone suggest that it could be worth checking I'd be going along with it.
At our latest visit the vet said well it could be his liver but he isn't screaming liver to me, of course we do need to check though. Glad we did.
Mine was also speculatively tested for cushings earlier in the summer, no symptoms, I've been glad I did given the amount of steroids he has required in the last few months.
It will only affect insurance if anything comes up, in which case you would rather know anyway I should think.

However I am struggling to see how it is possible to lunge on a 5m circle. What has occurred with the hock diagnostically so far?
 
Coblover63 said:
If both results come back clear I would ask for them to be deleted from your horse's records because you didn't ask for them!
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I think the visit was ridiculous, as he is with the same practice he should have had all the notes and history to hand and come to you expecting to do a further investigation on the hock, the fact he is being treated for ulcers while he is still undiagnosed/ treated for lameness will mean the ulcers are unlikely to heal fully however much GG is given, they are most likely a secondary condition relating to the ongoing pain which needs a proper diagnosis, if they cannot offer full diagnostics then he needs to be referred to somewhere that can.
 
Thanks for the info re getting it not affecting insurance assuming all is well of course. Unfortunately nothing has been diagnosed with his hock (I've got another vet from a different practice coming out on Monday). The first vet said there wasn't enough going on to work with, and this second one yesterday talked about everything from the problem being suspensory ligament through to kissing spine and needing a bone scan but then said he wasn't really lame and suggested the exercise routine of horse walker and lunging (sorry must have been 20m circle) to see if he gets worse. I think this particular practice are just after money, as he at one point said that if we leave the lameness for a couple of weeks or so and it gets worse then it will more than likely be a different claim from the ulcers claim and the insurance company won't link the 2 together.... He then went on a rant about buying joint supplements from them as opposed to on the internet and apparently from a quality point of view "its like Tesco vs Waitrose" ! I also got a lecture on how racehorses break their legs and I've still got no idea why, other than he was timewasting. My boy is an ex SJ and all I want to do is hack and some dressage !! My yard manager, head girl and a couple of the other very experienced horse women on the yard (plus me of course) can all see that he is definitely lame on his right hock and has been now for about 8 weeks. Hopefully 3rd time lucky on Monday with a different vet/practice.
 
I'm a bit confused by all of this to be honest.

As it stands am I correct in thinking the horse has been lame for 8 weeks, only been seen to by a vet twice and you're no closer to a diagnosis? If so I'd be seriously kicking up a fuss right now. Can this other vet not come out sooner? Leaving a horse in pain for the best part of another week really doesn't sit well with me.

When the first vet came out, what diagnostics were run?

I can't see the lameness being treated as a second claim if the first vet saw to it at the same time as diagnosing the ulcers, and if this all took place 8 weeks ago you've only got 10 months left to diagnose and treat the issue before you're past your 12 month point with your insurers. Which would be another reason I'd be pushing to get to the root of the problem pretty damn quick.

Best of luck with it all though. I know how stressful having a lame horse can be.
 
So just spoke to vet practice about having the tests removed from my records if nothing shows up. They told me in no uncertain terms that the tests will stay on my boy's records and cannot be removed. So I've cancelled the tests being run as this was the only way they would not be put on his records (and I won't be charged for them as I didn't ask for them in the first place) and will speak with the new vet on Monday, if he thinks they need to be done then I'll go along with it.
 
He is quite happy in himself, his demeanour has changed back to being a real sweetie again and no face pulling or ears back when being rugged up, and he has not been rested for over 3 weeks now. He's turned out every day and is not showing any signs of huge discomfort and still has a bit of a cavort around and roll for a couple of minutes when he first goes out. I don't believe he is in severe pain as during the 8 weeks he has hardly been worked because of the ulcer situation. 8 weeks ago the lameness was barely noticeable and the vet put it down to arthritic stiffness and sold me a joint supplement - there was also a suggestion that it may be ulcer related i.e. hind gut. I've ordered some Gastroplus to start him on from today so we'll see if that makes any difference. She did talk about a lameness work up when the ulcers had been resolved, but then as time went on she changed her mind and said he wasn't 'lame enough' and he is still being treated for ulcers. Other than trot him up, lunge him etc she didn't run any diagnostics as such - neither of the vets from this practice have. Believe me if I could get the new vet out sooner I would .... to be honest after yesterday's visit I'm more than confused ! :)
 
Someone correct me if I'm wrong, but I thought this sort of thing was only an issue with insurers if it came back positive?

From what I can gather, testing for cushings is now a fairly standard process for older horses so I'd be surprised if owners were penalised for running bloods to check whether the horse had cushings or not.
 
He's only just turned 12 - is that classed as older ? I'm happy to have the tests done if the new guy thinks they are needed but I've lost all faith in the last bunch, they've probably given me incorrect information anyway and are just being stroppy because I've left !
 
Our vets were recommending anything over 10yo was tested but I'm not sure whether that was just to encourage people to take advantage of the free testing month.

My last two horses have both been relatively young so it's not something I've had to particularly consider. But I know down this way there's a lot of encouragement to test any horses that might be susceptible.
 
New vet sounds like a good plan frankly!

I do understand the wait and see/try and make it clinically worse philosophy.
BUT there is an inextricable link between other physical issues and ulcers which would make me want to work up and throw some diagnostics at it sooner rather than later.
 
Cancelled the tests, which might have shown something or at least eliminated some causes? Does that mean you are more concerned about the insurance than early diagnosis of something which could be managed? Your insurers can't describe it as a pre existing condition, but they now could accuse you of concealing facts.
As for the exercise, maybe he should have explained but it can be the recommendation for something like bone spavin, to encourage any arthritic minor joints to fuse.
 
I resent the comment about being more concerned re his insurance and that I may conceal facts, it indicates that I care more about that than my horse. I, like most people with horses, am willing to spend whatever it takes to get him right with or without insurance I just refuse to put money into the pockets of people I do not trust or who I feel are ripping me off. As I said in my previous post I will speak to my new vet on Monday and if he thinks my horse should have these tests then I will go ahead with them.
 
TBF I can see that the OP felt rather railroaded into those test. Yes other things to do come up at appointments that might need intervention or discussing but it is the vets job to explain their reasoning and bring the owner along with that- to test cushings on a 12yo with no symptoms is a bit strange, and if the vet saw symptoms he should have explained that. The OP is getting another vet out and can presumably discuss the usefulness of these tests once he is there and whether to do them.

The most recent research seems to suggest that natural fusion of hocks occurs rarely and even if it does usually slowly, not from lungeing for a couple of weeks. The horse also has no diagnosis that that is the case anyway.
 
ester said:
New vet sounds like a good plan frankly!

I do understand the wait and see/try and make it clinically worse philosophy.
BUT there is an inextricable link between other physical issues and ulcers which would make me want to work up and throw some diagnostics at it sooner rather than later.
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I agree it sounds like a good plan. 12 is certainly possible for cushings. Mine was around 6 when he clearly had cushings.

I don't understand. Running blood tests seems very sensible and I would be wondering if the first vet should have done so. The blood tests may show some result which would help with diagnosis. Your objection to the blood test seems to be the insurance rather than the health of the horse. You asked for a second opinion, vet in his opinion thought bloods were needed. If they show anything you may be further forward if they don't I cannot believe that every clear blood test affects the insurance of a horse. Possibly when looking at the horse the vet did see potential liver, cushings or anything else problems. He didn't want to worry you but did want to check it out.

On a different note I had private health insurance and changed companies. I had to do the who health history thing. I had had exploratory tests for something. They were clear. I presumed the potential condition would be excluded on the policy. Not a bit of it. I was told that they were happy I had been tested and it was clear.

As you paid for the visit and for the blood taking it would be far cheaper to run the tests and see what they show.
As for the visit taking a long time then I have found vets do like to stand around and talk a lot. I offer coffee but always ask if it will be going on the bill. That works well as they often want to if they are not too busy. I get a chance to pick their brains for free!
 
right hindlimb lameness is VERY common with ulcers! omeprazole and stomach ulcers very often create inflamation in the hind gut and if you think how long the equine gut is and the position of the caecum you will understand holding themselves arkwardly on the right is understandable . treat the hind gut i use ranitidine (zantac) but there are a few supplements out there and he should come right . my boy took 6 months of treatment to get completely right -he stood with his right toe sticking out ,couldnt stand on his toes to wee,dragged his right hind toe and showed sacroilliac and hock discomfort. if he has a flare up of any of his symptoms i put him back on the ranitide for a couple of weeks .he perfectly sound since. tbh what have you got to lose!
 
I don't know how I can say this any more clearly ...... I Do Not Have a Problem with the Insurance Claim, just The Vets !!
 
Archiepoo said:
right hindlimb lameness is VERY common with ulcers! omeprazole and stomach ulcers very often create inflamation in the hind gut and if you think how long the equine gut is and the position of the caecum you will understand holding themselves arkwardly on the right is understandable . treat the hind gut i use ranitidine (zantac) but there are a few supplements out there and he should come right . my boy took 6 months of treatment to get completely right -he stood with his right toe sticking out ,couldnt stand on his toes to wee,dragged his right hind toe and showed sacroilliac and hock discomfort. if he has a flare up of any of his symptoms i put him back on the ranitide for a couple of weeks .he perfectly sound since. tbh what have you got to lose!
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Thanks Archiepoo - sounds just like my boy, he does toe drag very clearly (but vet couldn't see this either !) and its pointless talking to them about hind gut. We even tried to tack him up yesterday at the vets request, and when he had a pop at me and my yard manager vet tried to tell me it was behavioural and this is knowing that he definitely has ulcers .... he was a complete buffoon !
 
Dougal9 said:
I don't know how I can say this any more clearly ...... I Do Not Have a Problem with the Insurance Claim, just The Vets !!
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OK......Just amazed that you allowed for these tests to be carried out to start with.....I would have said 'No please deal with the problem I have called you out for!'
If you post on here then YOU will get various answers to YOUR question.....TBH I hope your horse is sorted out and some conclusion gives your horse the treatment that is needed.
 
I too wouldn't be amused at my vet taking bloods with little explanation.

Dougal9 - stick to your guns, get a new vet out and go from there.

I don't think you can be penalised by the insurance company for just taking bloods, but by the sounds of things current vets have let you down, I would loathe to give them anymore of my money.
 
paddy555 said:
I agree it sounds like a good plan. 12 is certainly possible for cushings. Mine was around 6 when he clearly had cushings.

I don't understand. Running blood tests seems very sensible and I would be wondering if the first vet should have done so. The blood tests may show some result which would help with diagnosis. Your objection to the blood test seems to be the insurance rather than the health of the horse. You asked for a second opinion, vet in his opinion thought bloods were needed. If they show anything you may be further forward if they don't I cannot believe that every clear blood test affects the insurance of a horse. Possibly when looking at the horse the vet did see potential liver, cushings or anything else problems. He didn't want to worry you but did want to check it out.
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See I disagree, it is really important the vet takes the client along with their thinking not to protect them for worry (if vet says you need to test you are going to worry anyway!) then you don't get in the situation that the owner feels they are being ripped off for unnecessary tests they weren't expecting.

BTW I do of course know it is entirely possible for a 12yo horse to have cushings, but to suggest testing on such a horse with no symptoms and not point out any symptoms/reasons for doing the test other than the lab tests being free at the moment seems wrong to me and almost sounds like the vet in question is making the most of pushing the free tests so they can charge for taking and sending the sample.
 
He muttered something about the vet who takes most bloods winning a holiday from the people who are sponsoring it ..... As he also went on to tell me about the dinners he has to go to with the reps who sell gastrogard I'm not entirely sure he was joking either !
 
Dougal9 said:
He muttered something about the vet who takes most bloods winning a holiday from the people who are sponsoring it ..... As he also went on to tell me about the dinners he has to go to with the reps who sell gastrogard I'm not entirely sure he was joking either !
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Seriously - he said that to a client!!! OMG if that is true then what on earth is happening to the veterinary profession? Joking or not that sort of comment is bang out of order and to me smacks of what you have said in earlier posts OP about that practice ripping you off. In all honesty I think you are much better off moving to a new practice.

tbh I'm not sure I'm a big fan of just blood testing for everything, even if the test is free. I had one of my boys tested for cushings a while back and OK the test was free, but it cost £90 for the vet to read the lab report and for me to call them to find out the result - note, I had to call them, they wouldn't call me . . . make of that what you will.
 
:eek3: at your vets too 3oldponies! I have had Frank tested speculatively twice once at 19, once at 23, both times no lab fees, both while they were there for something else and nowhere near £90!
 
Yep, £90 it cost me - honest and that was with a discount for paying within a few days of the invoice. I did complain - who wouldn't - as they'd not said anything at any point about paying for a free test to be read, I probably wouldn't have objected if it had been a more reasonable price, but that much just for reading numbers off an email! Anyway it has rather put me off blood tests now and if one is needed I always get a price in advance, it't not that I have a problem paying or having them done if necessary, but I'm never going to get caught like that again. They were really pushing that free test too, and if they were making at least £90 out of every one they did, I'm not surprised what an easy way to make money.
 
From what you said, he suspected liver problem so wanted to take bloods for that. The cushing test was then at no cost to you (as bloods were being taken and lab fee free, I suspect to benefit research on Cushing/ACTH in horses). Since your horse has soundness problems it is not OTT and no harm to the horse as his bloods were being taken.

Agree with the right hind lameness linked to hind gut acidosis comment (apparently technically it's acidosis not ulcer), have even heard it could be caused by Gastroguard... Bit of a chicken/egg problem.
Most importantly, what is the cause of the ulcers? Pain, management, stress? Not an easy question, I hope your horse gets better soon (I quite like Protexin acid ease if you are supplement inclined).
 
Palindrome said:
From what you said, he suspected liver problem so wanted to take bloods for that. The cushing test was then at no cost to you (as bloods were being taken and lab fee free, I suspect to benefit research on Cushing/ACTH in horses). Since your horse has soundness problems it is not OTT and no harm to the horse as his bloods were being taken.

The tests are free as paid for by the drug company, are they doing further research now the drug is approved for use in horses and we are paying so much more for it that when it was known as Pergolide and not approved, I have no idea but it would be interesting to know if anyone has ever been asked to take part in regular testing, they will obviously be collating the tests results and may be finding out things from that but it is definitely in the drug companies interests to get as many positive tests as possible so the horse can go onto Prascend and start paying off the cost of the blood test very quickly.

It would not surprise me if they are offering vets an incentive, after all they are all in business and it would be normal business practce to reward good results.
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Dougal9 said:
He muttered something about the vet who takes most bloods winning a holiday from the people who are sponsoring it ..... As he also went on to tell me about the dinners he has to go to with the reps who sell gastrogard I'm not entirely sure he was joking either !
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No it would not be a joke.
 
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