Coffin Joint Arthritis - am I missing something?!

[CJoe]

Hi Hive Mind of H&H

I have a 17 year old fresian x ID, all issues have either been teeth lungs or throat in the past so lameness is a new one on me!

Felt that he was slowing down in pace a little earlier this year, put it down to his asthma, wasn't lame....at all, still happily and willingly jumping.

Fast forward to April this year, felt "odd" non specific (typical navicular stuff but not "lame", still forward and keen" but felt shorter in stride. At a champ end of April had a couple of very uncharactisc stops, retired and didnt jump rest of the weekend. Got home, vet out...x rays, mri showed arthritis in pasterns low level and in coffin joints. Vet out again, nerve block....wasn't short in stride at all, looked great, had injections into coffin joints.

Usual rest of 48 hours in and then continue gentle riding. Which we did. However, subsequently he became lame in canter, despite being totally sound, better than a long time to be fair in walk and trot, striding out well and super keen to the point of jogging.

Vet out again, did a workup, still uncomfortable and pain.....in canter only. Vet felt feet were great, in good balance and no need to change anything at this stage.

I personally wanted to try pads to help him, no difference at all! His toes have been slightly rolled, he is not a horse to go barefoot, please dont go there! he has marvellous strong feet and hoof with good sole depth, but unless he is retired, barefoot wont be for him with out off road hacking being as it is.

Vet said to give it longer, I did, still lame in canter. Vet out again, said feet were "angry" quite non specific and recommended month of bute, 2 x for 2 weeks, 1 x for further two weeks.

We are now at the end of that, it didnt make too much difference. He is also on boswellia, vetrofen and his other supplements.

I am now at the point of changing vets, as I feel we are missing something that may help him. Hocks have been checked, fine....rest of him checked, fine.

My other issue is keeping weight of him as he will happily walk for hours and lose no weight! - he is on restricted grazing, been tested for PSSM just in case...

He also won't retire easily, he is already sulking when the lorry departs without him, he is bored, despite being hacked gently regularly and I just want to give him the best chance possible.

De nerving has been mentioned but I don't feel I want to go that route due to the possibility of not knowing if he was to get an abscess or other foot issue through not being able to feel the pain.

Thoughts? I am happy to ride and just walk n trot him, he isn't happy with this arrangement at all...........I suppose what I am struggling to understand is why he was able to canter (albeit gingerly before we came home from the away show, and since hasn't been able to without being uncomfortable, yet is pulling my arms out walking and trotting and full of the joys. Surely trotting would hurt too?

 

[Tiddlypom]

What were the coffin joints medicated with?

My mare responded very well to Arthramid in both front coffins. I lost her recently to a unrelated issue, but she stayed sound in front ever since she had the jabs 5 years previously.

 

[Alibear]

This is a pure guess based on my situational experience.
It may be that after having fixed/lesson pain in the fronts, your horse is now feeling pain elsewhere. I'd recommend scanning hind suspensories because every time I've "fixed" suspensories, I've discovered front foot pain. So, I'm guessing the reverse is possible.

I think your plan to try a different vet is a good one, and I've had luck with it. Even very good vets can get stuck on a previous diagnosis, and a fresh set of eyes can spot something new.

 

[Birker2020]

Hi Hive Mind of H&H

I have a 17 year old fresian x ID, all issues have either been teeth lungs or throat in the past so lameness is a new one on me!

Felt that he was slowing down in pace a little earlier this year, put it down to his asthma, wasn't lame....at all, still happily and willingly jumping.

Fast forward to April this year, felt "odd" non specific (typical navicular stuff but not "lame", still forward and keen" but felt shorter in stride. At a champ end of April had a couple of very uncharactisc stops, retired and didnt jump rest of the weekend. Got home, vet out...x rays, mri showed arthritis in pasterns low level and in coffin joints. Vet out again, nerve block....wasn't short in stride at all, looked great, had injections into coffin joints.

Usual rest of 48 hours in and then continue gentle riding. Which we did. However, subsequently he became lame in canter, despite being totally sound, better than a long time to be fair in walk and trot, striding out well and super keen to the point of jogging.

Vet out again, did a workup, still uncomfortable and pain.....in canter only. Vet felt feet were great, in good balance and no need to change anything at this stage.

I personally wanted to try pads to help him, no difference at all! His toes have been slightly rolled, he is not a horse to go barefoot, please dont go there! he has marvellous strong feet and hoof with good sole depth, but unless he is retired, barefoot wont be for him with out off road hacking being as it is.

Vet said to give it longer, I did, still lame in canter. Vet out again, said feet were "angry" quite non specific and recommended month of bute, 2 x for 2 weeks, 1 x for further two weeks.

We are now at the end of that, it didnt make too much difference. He is also on boswellia, vetrofen and his other supplements.

I am now at the point of changing vets, as I feel we are missing something that may help him. Hocks have been checked, fine....rest of him checked, fine.

My other issue is keeping weight of him as he will happily walk for hours and lose no weight! - he is on restricted grazing, been tested for PSSM just in case...

He also won't retire easily, he is already sulking when the lorry departs without him, he is bored, despite being hacked gently regularly and I just want to give him the best chance possible.

De nerving has been mentioned but I don't feel I want to go that route due to the possibility of not knowing if he was to get an abscess or other foot issue through not being able to feel the pain.

Thoughts? I am happy to ride and just walk n trot him, he isn't happy with this arrangement at all...........

I'd be tempted to try arthramid as although its more expensive than steroid it lasts much longer as is meant to be more effective.

I'd also query whether his soles were very thin from the deluge of rainfall through the winter months and maybe look at pads but the type that are made of gel - completely forgotten the name of it but its inserted into the sole of the foot with a bathroom sealant type thing and then it hardens in seconds. Anyone help me out?

 

[CJoe]

thank you for your replies, I will look into all those suggestions!!!!

 

[CJoe]

What were the coffin joints medicated with?

My mare responded very well to Arthramid in both front coffins. I lost her recently to a unrelated issue, but she stayed sound in front ever since she had the jabs 5 years previously.

basic steroids without looking at the notes xx

 

[sbloom]

I am now at the point of changing vets, as I feel we are missing something that may help him. Hocks have been checked, fine....rest of him checked, fine.

I've posted about horses that don't show specific clinical signs (yet) so the vets haven't been able to find anything, but the posture gives it away. If you were to compare to good examples on a site like equitopiacenter.com how does his posture look? I agree that there's a good chance there are other issues that are related to the front feet, ie a result of compensatory movement patterns.

 

[Birker2020]

Its called Equipak

 

[Zoeypxo]

Is he lame infront or behind in canter ?

 

[CJoe]

Is he lame infront or behind in canter ?

Starts into canter fine then after a couple of strides its REALLY evident his front feet hurt, he shortens and goes back to sound trot! the only thing I can compare it too is he looks like has has laminitis in canter! - no heat, i check daily with thermometer (we have minis/shetlands....). When nerve block was done on just his right front, he came sound. That is the foot with more arthritis in coffin joint, it all seems to relate to the movement of canter being different where it flexes the joint...as opposed to trotting and walking.

 

[ycbm]

"Angry" feet at 17 years old? Have you tested him for Cushings?
.

 

[CJoe]

Its called Equipak

View attachment 142353

thank you!

 

[CJoe]

"Angry" feet at 17 years old? Have you tested him for Cushings?
.

yes, and PSSM, ran bloods, nothing remarkable.......vet seems stumped that he is so sound in walk and trot, I was assuming soft tissue but nope.......he's such a jolly chap, and he is frustrated as we are!

 

[holeymoley]

Stifles?

 

[ycbm]

yes, and PSSM, ran bloods, nothing remarkable.......vet seems stumped that he is so sound in walk and trot, I was assuming soft tissue but nope.......he's such a jolly chap, and he is frustrated as we are!

OK, I would start from the position that says that canter is the only pace in which he is weight bearing on only one foot. I would assume that you have a problem in at least 1 foot/ leg which isn't, yet, bad enough to show up when there is another foot on the floor sharing the weight.

My first guess would be one hock but it could be another joint or a front leg.
.

 

[PinkvSantaboots]

Mine had arthramid and steroid in his coffin joints 2 years ago he was fine but about 3 months after treatment he kept tripping and just wasn't right in front, because he had previously been barefoot I took the shoes off and he has been fine since.

I would try the arthramid and possibly pads although I did go down the pads route and they worked for a bit then didn't.

The only other thing that springs to mind is hind end and or si joint it can impact the front end and the quality of canter can deteriorate.

My horse with the coffin joint arthritis also had hock arthritis and slight damage to suspensories all very mild all treated, he was looking good but the canter was crap just not really wanting to and looking choppy and not right, so my vet put steroid in the si joint and we saw an immediate improvement after the rest period.

He was 18 when all this went on his 20 now still being ridden but mainly hacking now as I don't thing the school was doing him any favours.

 

[doodle]

Similar to us. Horse has been lame since march on and off. Thought abcess, then bruising. Each time went lame again. Back to vets for blocks and x-rays. Blocks show it is in foot. Blocks also showed he was not lame on the other front foot. X-rays showed mild coffin joint arthritis. Horse is also 17. Treated with steroids. Seemed to help initially. Lame again by the 4 weeks mark. We think they didn't help and in fact what helped was the rest. So he had an MRI on Friday. Still waiting for results. He dosnt seem to have got better or worse. I'm not sure what I want the MRI to find. He is too lame to ride, perfectly happy in the field. But he is also getting bored and wants to do something.

 

[doodle]

He is currently without front shoes. He unhelpfully removed them as we also had to move yards 2 weeks ago. They would need removed for MRI so waited. Farrier didn't want to put then back on until MRI report too. So he is possibly feeling feet slightly, but is actually better than expected without them although he has broken them to bits.

 

[pistolpete]

So many things it could be. Neck back sacroiliac. He’s in pain and he’s honest to cope as he does in walk and trot. If he was mine he’d have a year off then a whole load of body work and very very slow re introduction of slow work. Lots in hand and over poles etc. Not what you want to hear I’m sure. He’s in a pattern now though which needs to change.

 

[CJoe]

So many things it could be. Neck back sacroiliac. He’s in pain and he’s honest to cope as he does in walk and trot. If he was mine he’d have a year off then a whole load of body work and very very slow re introduction of slow work. Lots in hand and over poles etc. Not what you want to hear I’m sure. He’s in a pattern now though which needs to change.

I'm very blessed to have other horses which friends want me to ride, and do some other competitions with the shetland. In all honesty this was my next move, taking shoes off and simply resting him. The weight is the only reason he's still hacking at all as my vet insisted on it. Lunging won't help the situation at all. He is such a good doer and gets a handful of sugar/starch free food to have his meds. But ideally he needs to be lighter!

I can't see the point of prodding and poking and spending even more money when a rest may do him more good, if he will tolerate it.

I've got a 2 year old who needs some time spent so plenty going on. Just don't want to make him worse nor do I want him depressed and bored out of work
, perhaps he would adjust?!

It's certainly a very possible option at this moment in time. He owes me nothing and has had a cracking career xxxx

 

[CJoe]

So many things it could be. Neck back sacroiliac. He’s in pain and he’s honest to cope as he does in walk and trot. If he was mine he’d have a year off then a whole load of body work and very very slow re introduction of slow work. Lots in hand and over poles etc. Not what you want to hear I’m sure. He’s in a pattern now though which needs to change.

I'm very blessed to have other horses which friends want me to ride, and do some other competitions with the shetland. In all honesty this was my next move, taking shoes off and simply resting him. The weight is the only reason he's still hacking at all as my vet insisted on it. Lunging won't help the situation at all. He is such a good doer and gets a handful of sugar/starch free food to have his meds. But ideally he needs to be lighter!

I can't see the point of prodding and poking and spending even more money when a rest may do him more good, if he will tolerate it.

I've got a 2 year old who needs some time spent so plenty going on. Just don't want to make him worse nor do I want him depressed and bored out of work
, perhaps he would adjust?!

It's certainly a very possible option at this moment in time. He owes me nothing and has had a cracking career xx

 

[sbloom]

Rest doesn't always fix things and can leave you worse off. If the vets can't find anything it may be useful to look for a more alternative type of bodyworker who focuses on movement, can assess posture, compensatory patterns etc to try and get a 360 degree view on everything going on. It takes a lot of experience to have this sort of lens, and an open mind. Otherwise I'd get vet, bodyworker and farrier (possibly saddle fitter) together for an hour and hash it out. Not cheap but ultimately the best way to get to the bottom if you don't want to go the purely vet diagnostics route, when you/they're guessing.

 

[lme]

I'd also recommend arthrimid for coffin joint arthritis

 

[RHM]

Really similar to my mare at the moment, really happy in walk and trot but the wheels fall off in canter. Treating as mild lami at the moment but I am convinced there is more going on too. Have a physio coming out to have a look. It’s really difficult isn’t it.

 

[CJoe]

Really similar to my mare at the moment, really happy in walk and trot but the wheels fall off in canter. Treating as mild lami at the moment but I am convinced there is more going on too. Have a physio coming out to have a look. It’s really difficult isn’t it.

It's a bit of a relief to hear someone else have the same issue! - I could find nothing online that presented like my boy, not with navicular or any other complaint! Interesting as I have been wondering if I should change his diet as he is a good doer (understatement) and I struggle with maintaining his weight at a good slim level currently due to reduced workload!

 

[RHM]

It’s certainly a strange one isn’t it! My mare even passed flexion tests I will let you know what the physio says, once she has been seen she will be going back into the vets to hopefully continue the work up. I’m suspecting it’s either something very high up or very low down!

Soaking my mares hay has made the difference for her with her weight, she is looking nice and horse shaped still at the moment!!

 

[CJoe]

It’s certainly a strange one isn’t it! My mare even passed flexion tests I will let you know what the physio says, once she has been seen she will be going back into the vets to hopefully continue the work up. I’m suspecting it’s either something very high up or very low down!

Soaking my mares hay has made the difference for her with her weight, she is looking nice and horse shaped still at the moment!!

Yes flexion tests in ALL legs fine! trotted off sound and bouncy! weight under control finally, allowed into fat side for a few hours and he has just galloped hard....a good 10 strides sound before bouncing to a stop, its defo his fronts...but I cannot understand how he is not lame at all in trot!!!! Be interested to see how you get on with your horse, best of luck!! x

 

[ycbm]

Yes flexion tests in ALL legs fine! trotted off sound and bouncy! weight under control finally, allowed into fat side for a few hours and he has just galloped hard....a good 10 strides sound before bouncing to a stop, its defo his fronts...but I cannot understand how he is not lame at all in trot!!!! Be interested to see how you get on with your horse, best of luck!! x

In trot he always has a hind leg sharing the weight with the front leg. In canter he doesn't.

 

[SEL]

The damage to the navicular bone in my big mare only showed up in canter and only in the field - my track was set up on a right bend from the field entrance and she was cantering on left lead even on the bends.

Vets were convinced laminitis (she'll never be skinny) but x rays showed pedal bone & overall balance fine but definitely problems with the navicular bone. Trotting her up in hand didn't show anything.

Nerve blocks had her cantering on that lead but she then looked odd behind. Steroid into her SI joint had her sound all round (following arthramid in hocks). Sound for about 5 minutes anyway she's a walking vet bill.

So I suppose I'm saying sound in trot doesn't always mean "sound". I've always said the trot up is dummies guide to lameness - most of us can spot a problem with the 2 time beat - but vets really earn their money when the problem is in canter.

 

[PinkvSantaboots]

When Louis started to buck and refuse to canter he had a workup at the vets and he had changes in the navicular bone and inflammation of the bursa and surrounding soft tissue.

He looked fine in trot but just didn't want to canter he was about 14 at the time his 19 now and his never had a problem since it was treated, he is barefoot now though and has been since then