Bone scan - outcomes?

[Soldier1994]

So on an initial poor performance came up with nothing. But he has certain behavioural problems that occurred very recently. Two different vets have recommended a bone scan because they couldn't find anything (i always get a second opinion...) they also recommended a physio appointment who found him to be sore on the right hand side, which we are putting down to him no longer fitting his saddle due to weight reduction (he was fat, really fat, now he's toned up! ) and is having a new saddle fitted next week.

Should I continue with his physio and new saddle before bone scan? - he's insured through the nose - if no improvement then bone scan? Or bite the bullet and get the scan done as soon as possible (we are based near Oakham so can be done relatively quickly)

If you've been in a similar situation, what sort of outcome did you have from a bone scan?

Picture of said handsome beast below.

 

[Goldenstar]

I am a big fan of bone scans .
Of course they don't show everything but if I was in your shoes I would have it done .

 

[ellie_e]

Personally I'd bone scan, you'll know exactly what's wrong then

 

[Goldenstar]

Personally I'd bone scan, you'll know exactly what's wrong then

Sadly not always some conditions will not show but it's the most comprehensive diagnostic we have for horses ATM .

 

[PorkChop]

If the insurance will pay, and you trust your Vets judgement, then I would have the scan tbh. They are expensive however you could easily tot up the cost of a scan with all sorts of other diagnostics.

 

[milliepops]

yes, and from an insurance POV you really want to get the diagnostics done as early as possible, otherwise the time you have covered for the episode (usually 12 to 18 months) will be trickling by while you don't really know what you are dealing with.

 

[Annagain]

My boy recently had a bone scan. He's 20, had been lame on and off for quite some time and when we tried nerve blocking he reacted very badly to the local anaesthetic so it was our only option. He's not insured so it cost us £1000 but we could have spent that randomly x-raying bits of him until we found the problem so it was definitely worth it. It turns out he has arthritis in his elbow so his jumping days are over but he's had the joint medicated and is back in work properly for the first time in 8 months so we're very happy.

They're a very useful diagnostic tool so if your insurance will cover it, go for it. Just be careful you don't max out the limit on diagnostics and have nothing left for treatment.

 

[criso]

Personally I'd bone scan, you'll know exactly what's wrong then

Probably more accurate to say you will know where there's something wrong.

Mine had one after nerve blocking to the knee had not revealed any issues. There was a hot spot on the shoulder. It took follow up x rays and ultrasound to find out exactly what was wrong (bone cyst) but the bone scan told us where to look.

 

[Soldier1994]

Looks to me bone scan asap is best option! If again nothing shows up, at least I'll know.

 

[BBP]

Mine had a bone scan that showed up an injury to the SI. That said, I have also recently found his continued poor performance really has been down to saddle fit - if you look at my recent post 'canter- before and after' you can see how much improvement changing the saddle has brought about.

 

[ihatework]

Bone scans are a good tool but they aren't perfect!
What a bone scan will do is highlight active areas of bone remodelling, often called 'hotspots' - now these hotspots may or may not be significant.
The vet will interpret the scan to suggest which hotspots might be the most significant for you. You will then often need additional imaging of the area for a more defined diagnosis. Unless there is bone involvement then soft tissue injuries don't show up. So there are limitations.

If you are under insurance and the vets say bone scan then I would do it sooner rather than later and certainly before forking out on a new saddle!

 

[Wheels]

My horse wasn't insured but I'd spent the best part of 6 months trying and failing to work out what was wrong and going through different sorts of rehab and physio programmes that were getting us nowhere so off we went.

I'm very very glad I did - he had bone remodelling in several areas, some of which would probably not have shown up on nerve blocks (neck and withers) and maybe none would since he had problems in both hocks and both sacroiliac joints, by the time we'd finished nerve blocking it probably would have been a similar price to the scan anyway.

 

[Annagain]

Probably more accurate to say you will know where there's something wrong.

Mine had one after nerve blocking to the knee had not revealed any issues. There was a hot spot on the shoulder. It took follow up x rays and ultrasound to find out exactly what was wrong (bone cyst) but the bone scan told us where to look.

I should have added something similar to my post. He still had to have the elbow x-rayed and nerve blocked (they used a different local anaesthetic as he reacted badly to the other) to be sure it was the only problem (as there were a couple of minor hotspots on his lower neck) but as he came 100% sound when the elbow was blocked they were happy that was a minor issue for a 20 year old horse. The scan itself (and associated stay in hospital costs) was £1000 the rest of the diagnostic work and the treatment (steroid injection and hyaluronic acid injection) and the extra days in hospital was another £1000.