Bone scan- is it worth having one?

[I don’t like mondays]

I posted earlier in the week worried about my mare. She’s not overtly lame but hops into trot, is now struggling to canter, reluctant to move forward, bucking. I’ve got her booked in for a workup and the vet has suggested a bone scan to pin point any issues. I’ve not had one of these before, I’m concerned about if a scan is worth doing and also worried how my mare will feel about being away from home (she’s nervous of vets). This will also use a lot of my insurance up (but this is what insurance is for in some ways). I’ve been scratching my head about her. Lots of people could put her ‘issues’ down to behaviour so would be good to know what’s going on. She’s green and quite weak and her symptoms are relatively intermittent and sometimes mild. A strong rider could probably ride her through it but I’d hate for her to be in pain and telling us

I’ve also now got a suspicion she could have PSSM (she’s a cob) so have ordered the test and will try Vit E and diet changes. Also been waiting for the saddle fitter (although she has symptoms in the field and on lunge)

So is a bone scan worth doing? Is it a bit OTT to do this with only mild intermittent symptoms? Do all horses show something on a scan or are they pretty accurate. I want to do the best for her. Thanks

 

[Trouper]

I did it with my mare - she was fine away from home but she did not like the travelling which, on later reflection, might have told me something as the bone scan did not reveal anything. At the time I hadn't heard of Tom Beech and, if I were now faced with the same situation again, I would want him to look at her first before committing to a scan (or even an op). There are so many soft tissue areas he can identify as possible problems that will not show up on bone scans that I would want to rule those out first using up my insurance on a scan.

 

[Annagain]

It's a tricky one, they're very good at pinpointing areas to investigate (as long as the issue is musculoskeletal) but a thorough work up with an experienced vet and nerve blocks could do the same. On the other hand nerve blocks can obviously only focus on one area at a time so might take a lot longer. Going straight for the bone scan might prove to be a genius move if you find something that would have taken several visits and several blocks to find (or that you'd never have found with blocks) or it might be a very expensive way of finding something that one set of blocks could have found.

We opted for a bone scan after months of intermittent mild lameness with my old share horse. He was rarely lame enough to nerve block and on the one occasion he was we ruled out the foot but he had a terrible reaction to the blocks, his whole front end swelled up, we thought we were going to lose him at one point as we couldn't stop the swelling and it took two months to get him back to normal. In that time he came sound but was lame within a few weeks of us riding again. There was no way we were going for more blocks after that so the bone scan was all we had left. He turned out to have an issue with his elbow which is very rare, especially without a trauma in the area) and we'd never have found it with nerve blocks.

The process was fine. Mont isn't the best away from home and isn't great stabled 24/7 (he goes on hunger strike) so we were worried but he coped. He came home a bit skinny and tucked up but soon put it back on. He ended up being there for 8 days due to a whole chain of events. Once the bone scan found the general area, they had to nerve block to confirm the diagnosis. Due to his previous reaction, they had to use a different drug to block that had to be ordered in and took an extra day, then the extra rest meant they couldn't get him lame enough to block so they had to work him hard for two days, then it was the weekend and the senior vets weren't around and eventually they decided they needed to monitor him for 24 hours after having the elbow medicated in case he reacted to that. That was all very unusual circumstances and most horses would be there a few days at most.

It won't help with something like PSSM so I'd explore that first.

 

[I don’t like mondays]

Thank you Trouper and Annagain- this is my worry to put her through all this and they find nothing so we’re none the wiser. I’m wondering about waiting for the PSSM1 results and starting on vit E and seeing where we are before sending her in for a work up? On the other hand I don’t want to be messing around for months when a bone scan could rule a load of things out. So hard to know what to do. She was going well then had a few weeks off and came back with increased issues (which makes me think PSSM)

 

[LEC]

Have had a couple done on the eventers. One last year as looked like a pulled muscle but it was a very talented horse so wanted to make sure it wasn’t sacroiliac as similar symptoms. It came back clean and the horse x rayed and scanned clean so it was a pulled muscle. The other was on an eventer who kept x raying clean but wasn’t right. Scan showed up hot spot in hock we then decided was bone bruising so had 6 months off. Came back to eventing at Novice.

 

[Pippity]

I'd wait for the PSSM results before committing to a bone scan. If she comes back positive, the vitamin E will start showing results within a week.

Once mine was diagnosed and started treatment, a whole host of niggling little issues vanished - launching into trot, no canter, bucking and broncing on the lunge. She still likes to throw in a few shapes when loose schooling, but that really is just exuberance!

She's a 15hh heavyweight cob, and she's on 8000iu of natural vitamin E daily, to give you an idea of dose. She has regular blood tests, and her vitamin E levels are now smack in the middle of where they should be.

 

[little_critter]

Mine have had a few bone scans. After the last saga I swore I’d have a bone scan sooner next time.
Horse was clearly unhappy, but not at all lame. She wasn’t insured so we tried the cheaper options first before going for a bone scan (ulcer scope, regumate, back x rays, Bute trials)
Sadly none of these pinpointed the issue and just delayed us getting a bone scan. The bone scan was quite clear, and the issue was not treatable so sadly the horse was PTS.
If you have a clear lead to work on, then take a look at them first. But given my time again I wouldn’t delay gating a bone scan if you are out of ideas.

 

[Annagain]

I think I'd sit down with your vet and have a really good chat about what they suspect and what you suspect and develop a plan of action as the diagnostics will be different depending on which theory they're trying to prove. Ask them to imagine she's not insured and to focus on what's most likely first.

 

[I don’t like mondays]

I'd wait for the PSSM results before committing to a bone scan. If she comes back positive, the vitamin E will start showing results within a week.

Once mine was diagnosed and started treatment, a whole host of niggling little issues vanished - launching into trot, no canter, bucking and broncing on the lunge. She still likes to throw in a few shapes when loose schooling, but that really is just exuberance!

She's a 15hh heavyweight cob, and she's on 8000iu of natural vitamin E daily, to give you an idea of dose. She has regular blood tests, and her vitamin E levels are now smack in the middle of where they should be.

wow, so that was all fixed from the vit E? Your second paragraph sounds like my pony at the moment

 

[I don’t like mondays]

Mine have had a few bone scans. After the last saga I swore I’d have a bone scan sooner next time.
Horse was clearly unhappy, but not at all lame. She wasn’t insured so we tried the cheaper options first before going for a bone scan (ulcer scope, regumate, back x rays, Bute trials)
Sadly none of these pinpointed the issue and just delayed us getting a bone scan. The bone scan was quite clear, and the issue was not treatable so sadly the horse was PTS.
If you have a clear lead to work on, then take a look at them first. But given my time again I wouldn’t delay gating a bone scan if you are out of ideas.

Sorry for your loss Littlecritter. Thank you for sharing your experience, sounds like it’s better to cut to the chase with a bone scan. I think I’ll try the PSSM test and vit E and if no joy will go for the bone scan

 

[Zoeypxo]

Worth doing yes, mine had it and found hock arthritis and also ruled out kissing spine which was a possibility from symptoms and behaviour.
Although it is very expensive if not covered by insurance.
Mine coped fine i think she was Away for about 4 days. She also had to travel 3 and a half hrs to get there and the same to get back.
She did drop a bit of condition from stress but was soon fine again!

 

[Pippity]

wow, so that was all fixed from the vit E? Your second paragraph sounds like my pony at the moment

Vitamin E and a couple of management changes. On my vet's recommendation, I switched her feed to one that, on paper, should have been worse for her (Saracen Re-Leve instead of speedibeet and unmolassed chaff) but she actually eats the Re-Leve. Her hay was already soaked for eight hours, so that didn't change.

The more exercise they get, the better, but it has to be consistent. I do my best to give her at least twenty minutes of trot/canter work a day, even if that's just loose schooling her. (She's a bit of a prat in the field, so probably gets at least that just hooning around with her herd, so I don't feel TOO terrible if I miss a day or two.) I got a sharer for her, and also pay someone to hack her once a week, so she gets more exercise than I can provide.

They also need to be kept a little bit warmer than a normal horse. I'm very much of a, "Keep them naked until they really need it," mindset, so this has been the hardest one for me!

This is what works for me, but there's the usual caveat that all horses are different, especially PSSM horses.

 

[Bonnie Allie]

If you are heading off to the vets - get everything possible done, even if it means staying in the clinic for a couple of days. Staff are great in the clinics and really know how to keep the horses calm and relaxed for their stay.

You want to be getting a complete diagnosis using the best tech available.

 

[I don’t like mondays]

Thanks so much for everyone’s insight and help, really useful and appreciated. I’m going to send her in for a workup and possible bone scan while also testing for PSSM. May as well cover everything off to get answers

 

[criso]

I found it really helpful for a horse that clearly defined lameness but a full hospital workup and nerve blocks didn't pinpoint the issue. It was a bone cyst in the shoulder which is pretty obscure condition, something more common or lower down might have come to light in the initial investigations.

 

[maya2008]

My advice would be to get the most experienced vet you can, then talk about what exactly they will do and why. It’s a bit like with cars - an experienced mechanic can take a good guess at the problem at the start, then narrow it down; a less experienced one charges you a fortune at the start by plugging the computer in just to find the spark plugs have gone.

 

[ycbm]

Bear in mind also that they are made radioactive for a time by a bone scan and nobody can go in the box with them. Unless things have changed since the last time I heard about one, she will be left without being mucked out and with hay thrown in but no contact for 2 days until. she is safe to go near.
.

 

[I don’t like mondays]

Bear in mind also that they are made radioactive for a time by a bone scan and nobody can go in the box with them. Unless things have changed since the last time I heard about one, she will be left without being mucked out and with hay thrown in but no contact for 2 days until. she is safe to go near.
.

Gosh I didn’t know that. I knew they had to be quarantined to some degree but that sounds really stressful and a recipe for ulcers. Would you try other diagnostics like SI scan and hock X-rays first in my position?

 

[Zoeypxo]

Gosh I didn’t know that. I knew they had to be quarantined to some degree but that sounds really stressful and a recipe for ulcers. Would you try other diagnostics like SI scan and hock X-rays first in my position?

• Your horse will be injected with a radioactive isotope at around 10-11am on the morning of the scan.
• Your horse will then be scanned approx. 2 hours later using a special camera, called a gamma camera. This detects the radioactivity coming from the skeleton and a series of images are produced. This enables us to detect ‘hot spots’ (regions of increased radioactivity) that may be considered abnormal.
• Once the scan has been carried out your horse will return to his/her stable and has to remain in that stable until midday of the following day. Unfortunately you are unable to visit your horse during this time. This is due to safety regulations with regard to the use of radioactive materials.

 

[Zoeypxo]

^ thats what i was sent when my horse went in for one at B&W gloucestershire.
My horse was totally fine and was in a barn with other horses for company. They rang me everyday to tell me she was ok/results. They treated the problem on the last day and sent her home. Pretty easy and id 100% do it again. I spent thousands on nerve blocks and x rays and had to eventually do the bone scan anyway!

 

[ITPersonnage]

Just echoing what Zoeypxo said, my girl had a bone scan and was completely unperturbed by it, in fact she loved the vet clinic after that and was reluctant to come home It's a very useful tool but normally after soft tissue has been ruled out I think.

 

[I don’t like mondays]

^ thats what i was sent when my horse went in for one at B&W gloucestershire.
My horse was totally fine and was in a barn with other horses for company. They rang me everyday to tell me she was ok/results. They treated the problem on the last day and sent her home. Pretty easy and id 100% do it again. I spent thousands on nerve blocks and x rays and had to eventually do the bone scan anyway!

Thank you, that’s very helpful

 

[Melody Grey]

Thanks so much for everyone’s insight and help, really useful and appreciated. I’m going to send her in for a workup and possible bone scan while also testing for PSSM. May as well cover everything off to get answers

Did you get her scoped? The symptoms you mention at the top of the thread can present with ulcers in my experience. What the cause might be/ whether there is one are also then valid questions!

 

[Melody Grey]

….I’m starting to explore PSSM more with one of mine…who also has a history of ulcers. From what I read, there is a link.

 

[I don’t like mondays]

Did you get her scoped? The symptoms you mention at the top of the thread can present with ulcers in my experience. What the cause might be/ whether there is one are also then valid questions!

Not scoped yet but that’s a very good point and something I should probably look at too, thank you

 

[ycbm]

Gosh I didn’t know that. I knew they had to be quarantined to some degree but that sounds really stressful and a recipe for ulcers. Would you try other diagnostics like SI scan and hock X-rays first in my position?

Yes.
.

 

[ycbm]

• Your horse will be injected with a radioactive isotope at around 10-11am on the morning of the scan.
• Your horse will then be scanned approx. 2 hours later using a special camera, called a gamma camera. This detects the radioactivity coming from the skeleton and a series of images are produced. This enables us to detect ‘hot spots’ (regions of increased radioactivity) that may be considered abnormal.
• Once the scan has been carried out your horse will return to his/her stable and has to remain in that stable until midday of the following day. Unfortunately you are unable to visit your horse during this time. This is due to safety regulations with regard to the use of radioactive materials.

I read several sites before posting that said 48 hours.
.

 

[Pippity]

….I’m starting to explore PSSM more with one of mine…who also has a history of ulcers. From what I read, there is a link.

My vet originally suspected ulcers with mine, and we did have her scoped. (The vet now uses those images as an example of a perfect stomach without a hint of ulcers!) It wasn't until she tied up that either of us thought of PSSM.

 

[little_critter]

I’ve sent 2 horses for bone scans. Neither appeared stressed when i picked them up.

 

[criso]

Mine was 24 hours at the rvc. I collected him the next day and they'd already done x rays and nerve blocks to confirm the diagnosis.

The only issue i had was the isolation box was in the block that can't have straw and he was allergic to shavings so we decided to have him just on mats for 24 hours. He was fine though, RVC was his favourite 5 star hotel. He was allowed straw in other block where i collected him.


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