Bone Density Scans - Anyone had any experience of them?

[SamBean]

Morning,

I guess as above really, my vet is suggesting this is the next step to work out issues of back pain in my lad. He is so well mannered and only first came to light as I booked him physio and he wouldn't let near, it was an extreme reaction yet no issues when I have been riding him. I'd only started light hacking on him at this point after down time from racing and after initial nerves about going out on his own is really quiet and no indication he wasn't happy. X-rays were fine and trotted up fine, tried bute to see if made any difference too. Had him scoped and has been treated for grade 3 ulcers plus also in his lower stomach which the gastroguard didn't touch. Tried physio 2-3 times since and although will let her near his front end, he still reacts pretty extreme if she goes anywhere near his back. It is not trying it on, he means it. I'd have to send him away if I went with the scans, I'm worried about travelling him, the stress for him and if anything was picked up would it be only to confirm that he needs to be retired? I don't want to put him through more if that is all it will be so guess I'm after some others experiences good or bad. I'm not riding him , I felt he was actually scared last time I went to take him out although he behaved I could feel he was tense and don't want to put us or anyone else in danger if he does explode which I feel he may well do if we have unresolved / unanswered issues. If anyone could share experiences I'd really appreciate it, thanks.

 

[Pearlsasinger]

I haven't had scans done and I understand your concerns re travelling, stress etc. I have had very good results from acupuncture - and nowadays this can be done by laser, rather than needles, so that the back doesn't even have to be touched, if it's too painful. I would try to find a professional, either vet or physio who will try acupuncture with him. My vet does it.

 

[ihatework]

I’ve never known a horse have a bone density scan (DEXA), so I assume you mean a bone scintigraphy/bone scan, which highlights areas of bone turnover? These are common in horses.

They are a useful tool but have their limitations and whilst it could well be useful to have one I’d be inclined to send your horse away for a work up at good orthopaedic hospital (if you are insured - if not you need to carefully consider your finances)

Otherwise it’s good old Dr. Green and keep fingers crossed it’s soft tissue

 

[ycbm]

Do you mean a gamma ray scintigraph?

That will show up any areas of active bone remodelling. I've heard of it being done many times, sometimes very helpful. If my ex racer was showing the kind of issues yours is I might go for it, be sure a piecemeal approach to testing to try and find out what's wrong could end up even more expensive. Downside is that if the problem is a soft tissue one, or includes a soft tissue one, it won't help.

They are made radioactive by the process and have to left alone in a closed box for several days, I think. No mucking out, no contact at all, hay chucked in quickly and left.

I think in your situation I might just retire him, or chuck him out for a year and see where he's at then.

.

 

[be positive]

Others have answered above about the scans and offered ideas as to which way to go but if you want to spend some time first I would treat him as a rehab and play about first with him yourself which will do no harm and may allow any vet or physio to get a better idea when they do look at him.

Does he let you massage his back? if you have not tried then do a little every day, use a very gentle approach, take your time to feel what he does accept and enjoy, gradually go in and out of the less easy places, you may need to start on the shoulders until he realises you are not going to cause pain and actually relaxes, spending time on this should make it easier for the physio as well as being good for him.
Do stretching exercises and some in hand work while you cannot ride, maybe some long reining/ easy lunging all aimed at loosening his back and giving a clearer picture of how he is moving, I would expect it to be soft tissue involvement if his back xrays were clear so am unsure what more you can find by having a full scan and using up a large part of the insurance money on just one diagnostic tool.

I went to the vets with a horse yesterday for various tests and came back with a totally unexpected possibility to what is wrong, she has a sore back and it is now pointing to her front suspensory ligaments being the primary issue, nowhere near her back, I can see the value of looking at the bigger picture but in our case I dont think a bone scan would have helped at all.

 

[Goldenstar]

I would have a bone scan done in the situation you describe if throws up lots of issues you have an answer it’s a retire or PTS situation .
It’s sometimes the cheapest way to get this answer .

 

[SamBean]

I haven't had scans done and I understand your concerns re travelling, stress etc. I have had very good results from acupuncture - and nowadays this can be done by laser, rather than needles, so that the back doesn't even have to be touched, if it's too painful. I would try to find a professional, either vet or physio who will try acupuncture with him. My vet does it.

Thank you, and I agree Acupuncture is amazing, I had a dog with wobblers regularly treated but unfortunately she moved to Luxembourg. I'd like to know the cause as well as treat the symptoms and he is quite happy being a field ornament and being spoiled. We did try laser once and found out after when I spoke to his trainer that he has regularly had laser treatment - just one glance and there was no chance! Saying that we've not tried since his ulcer treatment so could be something to revisit with him, thank you.

 

[SamBean]

Thank you for so much input and thoughts - iHW, yes he is insured and whichever way I go from here it will be a new claim if I decide to take it further though I would have to have full confidence before sending him away as it would be putting him through a lot in itself.
He last raced in March 2017 just shy of 10 years, and had a good 6 months down at the yard with his trainer before coming to me where he also had 3 months down before I started anything. I'd say at most he has had 6 months light hacking. His front end is very loose and free so we would hope the rest of him is but we can't assess.
BePositive, he will let me brush him off though I do watch out behind his saddle area where he seems most reactive and I can tough him but I don't think he would take to me trying to massage him there although he lets me massage his neck and shoulders and stretch his fore legs out too.
I'll be honest and probably thinking along the lines of YCBM and Goldenstar suggestions, at least then I know I have looked at everything I can and make a clear and informed decision despite having to move him. My husband is keen to send him too which is good he is supportive as in his words 'he is such a lovely horse and personality.'

 

[ihatework]

The vet has seen him and started X-ray investigations therefore it’s a claim continuation from the day you first called the vet (you have 12 months).
That is the point of insurance - I’d use it. He is an ex racer so used to travelling - I’d just send him to a good hospital and ask them to work him up

 

[Fanatical]

I have had a horse bone scanned in the last 12 months. Whilst I am aware it doesn't capture every issue, for me and the horse in question it was amazing - we would never have known the extent of the horses issues without it - and indeed if the vet had xrayed certain parts of the body and found an issue beforehand, we may never have known just how bad the horses situation was.

In my horses case he was in the hospital for 5 days (4 night). I dropped him off on the Monday and collected him late Friday PM. As another posted said above, they inject them with a radioactive substance and run the scan which shows up hot spots in potential problem areas. The horse is then put in an isolation stable for 24-48 hours and only has the very basics seen to - ie: hay thrown in, during this period, they are not mucked out or touched in any way. After this isolation period, further investigations such as scans or xrays can be run on the areas that showed as hotspots to try to establish what the problems are.

I would definitely not hesitate to send a horse for another one should the situation arise. Invaluable piece of technology!

 

[SamBean]

The vet has seen him and started X-ray investigations therefore it’s a claim continuation from the day you first called the vet (you have 12 months).
That is the point of insurance - I’d use it. He is an ex racer so used to travelling - I’d just send him to a good hospital and ask them to work him up

Unfortunately with the scopes and ulcer treatment I'm pretty up to my limit on the open claim so I'm assuming it would have to go as a separate one though I have not had anything confirmed yet. I'm sure he will travel fine, but even with food bribes I can't get more than a foot on the trailer ramp at the moment so may have to sedate him.

 

[SamBean]

I have had a horse bone scanned in the last 12 months. Whilst I am aware it doesn't capture every issue, for me and the horse in question it was amazing - we would never have known the extent of the horses issues without it - and indeed if the vet had xrayed certain parts of the body and found an issue beforehand, we may never have known just how bad the horses situation was.

In my horses case he was in the hospital for 5 days (4 night). I dropped him off on the Monday and collected him late Friday PM. As another posted said above, they inject them with a radioactive substance and run the scan which shows up hot spots in potential problem areas. The horse is then put in an isolation stable for 24-48 hours and only has the very basics seen to - ie: hay thrown in, during this period, they are not mucked out or touched in any way. After this isolation period, further investigations such as scans or xrays can be run on the areas that showed as hotspots to try to establish what the problems are.

I would definitely not hesitate to send a horse for another one should the situation arise. Invaluable piece of technology!

Thank you so the scans would cover all of him and not just his back then? Did you manage to address your horses problems then as a result or did you get clarity as a result? I was convinced it would just confirm there was a problem and that we wouldn't be able to work through it.

Sorry - i forgot to ask, how long was he away for and was he x-rayed there too?

 

[Fanatical]

Thank you so the scans would cover all of him and not just his back then? Did you manage to address your horses problems then as a result or did you get clarity as a result? I was convinced it would just confirm there was a problem and that we wouldn't be able to work through it.

Sorry - i forgot to ask, how long was he away for and was he x-rayed there too?

i had had my horse scoped prior to the bone scan for which he had a month of treatment on ulcer kind. This was covered as a separate claim on the insurance. However if you have had xrays this may well end up needing to be part of the same claim as the gamma scan.

You/ your vet can request full body or parts of the body. We had no clue what was going on with my boy and so we went with full body and I am so glad we did.

He was away for 5 days/ 4 nights Monday to Friday. The scan results can be followed up either by the hospital whilst they are there, or back with your own vet. I also had travelling issues with the horse in question (I think he was in pain when travelling) so I opted to have all investigations carried out whilst he was there.

it really depends what the findings are as to what the prognosis is. My horse was very sadly PTS as a result of the findings as that was the right thing for him.

 

[AandK]

My 22yo had a bone scan in the distant past, it helped rule out some areas. With regards to physio, can your horse not be sedated in order to allow him to have a treatment? Could help get him started, just an idea.

 

[SamBean]

i had had my horse scoped prior to the bone scan for which he had a month of treatment on ulcer kind. This was covered as a separate claim on the insurance. However if you have had xrays this may well end up needing to be part of the same claim as the gamma scan.

You/ your vet can request full body or parts of the body. We had no clue what was going on with my boy and so we went with full body and I am so glad we did.

He was away for 5 days/ 4 nights Monday to Friday. The scan results can be followed up either by the hospital whilst they are there, or back with your own vet. I also had travelling issues with the horse in question (I think he was in pain when travelling) so I opted to have all investigations carried out whilst he was there.

it really depends what the findings are as to what the prognosis is. My horse was very sadly PTS as a result of the findings as that was the right thing for him.

Oh no, I shed a tear at this, so sorry Thank you for sharing though. I'm feeling better prepared now to make a call and think I do need to send him for peace of mind and see what is going on. If only they could talk!

 

[SamBean]

My 22yo had a bone scan in the distant past, it helped rule out some areas. With regards to physio, can your horse not be sedated in order to allow him to have a treatment? Could help get him started, just an idea.

Thank you, yes we discussed sedation but the fact we can get around his front is seeing as a pain reaction more than muscular so we decided against it. His physio has never come across a horse she cant get around before like this, you can see he knows her now the way he interacts but just can't let near.

 

[Fanatical]

Oh no, I shed a tear at this, so sorry Thank you for sharing though. I'm feeling better prepared now to make a call and think I do need to send him for peace of mind and see what is going on. If only they could talk!

Happy to help. best of luck with it all. It is best to find out what is going on and then you know what you are dealing with.

In my experience, when horses don’t cooperate they either don’t understand, or more likely, they are in pain.

 

[SamBean]

Happy to help. best of luck with it all. It is best to find out what is going on and then you know what you are dealing with.

In my experience, when horses don’t cooperate they either don’t understand, or more likely, they are in pain.

Thank you, you have been a massive help. I'm going to speak to my vet and ask some questions and for more information but I'll be honest I was leaning against sending him until you came along. Your situation sounds similar to mine. I don't want to stress him by sending him away but if I 'give up' on him without trying to get to the bottom of it I don't know how I'll be and always wondering 'what if?'

 

[ester]

It might be helpful to sedate him so the physio can get there hands on him and see what they feel/where he actually reacts. But I would probably still likely go for bone scan/other work up so I could make an informed decision about his future.

 

[Pearlsasinger]

Thank you, yes we discussed sedation but the fact we can get around his front is seeing as a pain reaction more than muscular so we decided against it. His physio has never come across a horse she cant get around before like this, you can see he knows her now the way he interacts but just can't let near.

He may have pain in his muscles!

 

[be positive]

Bute may be contraindicated with the ulcers but has a short trial been considered? being pain will cause them so the gamble may be worthwhile, ours was extremely grumpy and anxious and became much more relaxed within days of going on bute, it is not definitive but if it helps he may be more comfortable for the physio and sometimes it does help clarify matters, it would have to stop if he is going in for a scan but it could give you a few days with him pain free to at least try loading him.

On the traveling issue most racehorses will never have been in a trailer so look into hiring a 3.5 ton box for the journey, unless it is a very short journey I would not want to travel a sedated horse in a trailer the thought of what could happen if they came out of it and had a major panic does not bear thinking about and not worth the risk, if he is in pain it can make traveling even more difficult, it is not ruling out taking him but the journey does need to be considered and well planned if he is not an easy loader.

I had one that was great in a lorry but was not always happy in the trailer, he was actually still racing at the time and he had a fairly major panic, lost his footing, kept fighting to stand up despite the fact I was barely moving, I had to pull in to a local yard to unload and he hacked home with a bandage on his cut leg, he had never done this before and never again but only went in the lorry after that day, if I had been miles from home or on a motorway I dread to think what damage he would have done to himself.

 

[little_critter]

I’ve experienced 3 bone scans, 2 with one pony, one with my mare earlier this year. They have never appeared stressed when I’ve picked them up, even though they were in a quarantine box. The most recent time I was surprised that the specialist had done additional tests including a rectal exam before the radiation quarantine period was over so they might not always be quite as hands off as I thought they would be.
I put off the bone scan for my mare as she wasn’t insured. I tried physio, ulcer treatment (scope showed she had ulcers, in hindsight probably secondary to her back problem), regumate , steroid injections.
When none of that worked (and wasted about 6 months) I stumped up for a bone scan which showed she had an unusual back condition which was untreatable and she was PTS shortly afterwards (I stress it was a rare condition, don’t panic OP!)
I put her through unnecessary tests and test riding for 6 months while I tried cheaper options.
If I had my time again I’d go for the scan early on.

 

[SamBean]

Bute may be contraindicated with the ulcers but has a short trial been considered? being pain will cause them so the gamble may be worthwhile, ours was extremely grumpy and anxious and became much more relaxed within days of going on bute, it is not definitive but if it helps he may be more comfortable for the physio and sometimes it does help clarify matters, it would have to stop if he is going in for a scan but it could give you a few days with him pain free to at least try loading him.

On the traveling issue most racehorses will never have been in a trailer so look into hiring a 3.5 ton box for the journey, unless it is a very short journey I would not want to travel a sedated horse in a trailer the thought of what could happen if they came out of it and had a major panic does not bear thinking about and not worth the risk, if he is in pain it can make traveling even more difficult, it is not ruling out taking him but the journey does need to be considered and well planned if he is not an easy loader.

I had one that was great in a lorry but was not always happy in the trailer, he was actually still racing at the time and he had a fairly major panic, lost his footing, kept fighting to stand up despite the fact I was barely moving, I had to pull in to a local yard to unload and he hacked home with a bandage on his cut leg, he had never done this before and never again but only went in the lorry after that day, if I had been miles from home or on a motorway I dread to think what damage he would have done to himself.

Thanks, I'll mention another bute trial when I speak to my vet, definitely could be worth another go. I think good point with the journey too as it is about an hour away. I was told by someone on the yard they will travel in anything and when we went to look at them 2 turned up in a trailer from their vets so kind of 50:50 really. To handle day to day he really is a saint, I can't fault him. He is so quiet and well behaved so to see these reactions really are so extreme in him and quite upsetting to see. I had half convinced myself the first time I had imagined it until the vet came to examine him.

 

[SamBean]

I’ve experienced 3 bone scans, 2 with one pony, one with my mare earlier this year. They have never appeared stressed when I’ve picked them up, even though they were in a quarantine box. The most recent time I was surprised that the specialist had done additional tests including a rectal exam before the radiation quarantine period was over so they might not always be quite as hands off as I thought they would be.
I put off the bone scan for my mare as she wasn’t insured. I tried physio, ulcer treatment (scope showed she had ulcers, in hindsight probably secondary to her back problem), regumate , steroid injections.
When none of that worked (and wasted about 6 months) I stumped up for a bone scan which showed she had an unusual back condition which was untreatable and she was PTS shortly afterwards (I stress it was a rare condition, don’t panic OP!)
I put her through unnecessary tests and test riding for 6 months while I tried cheaper options.
If I had my time again I’d go for the scan early on.

Thank you, it seems extreme sending him away and despite my reservations I really am thinking more and more that I should to for it and give him the chance and get some answers. I feel I'll be having a long chat with my vet!

 

[ester]

It is definitely not extreme, people do it with very normal horses and ponies every day of the week

 

[little_critter]

Agree - not extreme at all. I reiterate neither of mine were at all stressed when I picked them up after a few days (one of which kicked a hole in my stable when I first bought her and she took a few days to settle...so if she was stressed I would have known about it!)
Speak to your vet. Understand what the scan will and won't show you.
Understand that the scan is not a diagnosis...it really only guides the vet as to where to investigate. So further tests will almost certainly be needed after the scan to follow up on what it shows.
Ask your vet...if the scan is inconclusive then what next?
I also had a bit of a think beforehand on 'what ifs'. So I had in my mind what interventions and surgeries I would / wouldn't put my horse through. Also maybe think about what outcomes are acceptable to you. Do you NEED to have your horse back to 100% fitness? Are you happy with hacking only / light work? Are you happy to retire your horse if needed? (I only ask this because that might affect what treatments / surgeries etc you agree to; if the surgery would bring them back to being able to do hacking only would you go for the surgery or opt for something else?)
Sorry if all of this is jumping the gun and a bit heavy, it's just some of the things I was thinking through when I went through this.

Good luck - I hope you have a good outcome.

 

[SamBean]

It is definitely not extreme, people do it with very normal horses and ponies every day of the week

Thanks, I guess it feels like it with sending him away this time and he won't be close to me.

 

[little_critter]

Thanks, I guess it feels like it with sending him away this time and he won't be close to me.

Yes - it is a bit odd but for you more than him. I didn't know what to do with myself if I wasn't going to be mucking out / poo picking etc etc etc for a few days. The lie in was nice though

 

[SamBean]

Agree - not extreme at all. I reiterate neither of mine were at all stressed when I picked them up after a few days (one of which kicked a hole in my stable when I first bought her and she took a few days to settle...so if she was stressed I would have known about it!)
Speak to your vet. Understand what the scan will and won't show you.
Understand that the scan is not a diagnosis...it really only guides the vet as to where to investigate. So further tests will almost certainly be needed after the scan to follow up on what it shows.
Ask your vet...if the scan is inconclusive then what next?
I also had a bit of a think beforehand on 'what ifs'. So I had in my mind what interventions and surgeries I would / wouldn't put my horse through. Also maybe think about what outcomes are acceptable to you. Do you NEED to have your horse back to 100% fitness? Are you happy with hacking only / light work? Are you happy to retire your horse if needed? (I only ask this because that might affect what treatments / surgeries etc you agree to; if the surgery would bring them back to being able to do hacking only would you go for the surgery or opt for something else?)
Sorry if all of this is jumping the gun and a bit heavy, it's just some of the things I was thinking through when I went through this.

Good luck - I hope you have a good outcome.

I think you have hit the nail on the head here - i really do need to have that chat and yes I'm worried about ulcers and stress and also my other horse who will find himself alone for a few days.
As to further tests and outcomes, if there is something degenerative then I won't consider any surgery to prolong and again I'd have to think really hard about any high risk surgery.
I had asked the trainer I got him from for a horse whom would be suitable for hacking so if he could be at a point of light hacking I would be so overjoyed I can't express how amazing that would be. If we could ever make it to a fun ride or be able to take him to a change of scenery it would be a bonus but not the be all and end all.
If he had to be retired then I would be asking questions and have to discuss with my family options, he is very much a family horse and loved by us all. I guess again it depends on what the results show up. I wouldn't loan him as a companion as hear so many horror stories and would have nightmares about losing contact to find he has been sold as a ridden horse or anything.

 

[ester]

Genuinely mine had a jolly the few times he has had to have a stay over for treatment. Until the attending nurse worked out just how much haylage he was eating.

Usually the more info you have the better picture you can build and the better the decision you can make.