Coffin Joint Arthritis

thedutchess

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26 September 2014
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Hi everyone, I’m boy has been diagnosed with coffin arthritis in February he’s had never blocks xrays, he was initially lame only in trot, I had the joint injected recommended by the vet, now I think it’s the worse thing I could have let happen, he is now lame in walk one day then not, I’m puzzled I’m having the vet out again on Monday to see if they can do anything else, I’m so upset I brought him in August of last year and he was turned out for a month and not ridden until my yard was finished, we come back to the yard and after a few weeks he started intermittently lame and it’s taken until February to get a diagnosis, can anyone give me any hope? If not can you tell me any info as I’m thinking of put to sleep if nothing else can be done
Read more at https://forums.horseandhound.co.uk/threads/coffin-joint-arthritis.773695/#YshsQ9JgKaUd3Vpe.99
 

ester

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Injecting would be a very common thing to do and I would always do it as a first option. Some seem to do better on different types but there are also other medical options if it doesn’t work. Is he shod?
 

thedutchess

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Yes he is shod I did try taking his shoes off but that’s lasted all of 24 hours he couldn’t cope I could hardly walk without them, is there different types? I didn’t know that I will mention this to my vet, I feel so hopeless I’ve been crying all day he’s auch a sweet boy
 

Theocat

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It could be something else, rather than the coffin joint, which is now showing as lameness. You need a vet's opinion.

How long has he been lame since you first noticed it?
 

thedutchess

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x
It could be something else, rather than the coffin joint, which is now showing as lameness. You need a vet's opinion.

How long has he been lame since you first noticed it?
It first started October time when he returned to work, he’s had box rest on Bute, like I say at first it was intermittent then just after Christmas it was worse and haven’t ridden since he had the injection the first week in feb, the vet thought maybe he had an infection at first as he went from lame in trot to lame in walk, they came back out and took some of the fluid back out and tested it all was fine the seemed stumped that’s why they want to comeback back out
 

Fjord

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Did your vet suggest remedial shoes? My mare had coffin joint arthritis and was off work for a few weeks. Treatment was Bute and straight bar shoes with gel inserts, after a year (when the insurance stopped paying for them) we dropped the inserts but she still has the straight bars.
 

ester

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I’d want shoes that eased the breakover as much as possible too if going that route.

Am I right in thinking he initially improved after the joint injection?
Was he tested with other hoof nerve blocks. I think we had to go back a second time for the coffin joint nerve block as the palmar one can interfere.
What sort of level of change did he have on X-ray?

We had a coffin joint djd diagnosis on the basis of blocks- nothing on X-ray. Got about 4-6 weeks benefit from injection and got foot balance much better in shoes but still lame.
came sound barefoot and suspect djd wasn’t the issue or the whole problem.
It is possible to transition with use of boots for sore horses but I think it depends on what the xrays looked like as they will compromise break over.
 

starfish8

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Yes, mine has arthritis in pasterns and coffins, diagnosed in november. She's not had the joints injected but has not long had her second dose of tildren. There was also ligament involvement, so has had hyaluronic acid and cartophen, and is shod with rolled toes to aid with the breakover point - on vets instructions. She's now on a pretty strict rehab programme as advised by the vet, and seems to be doing well. She's sound, feels much more like her normal self (i.e. a menace) than pre-diagnosis and vet has said she should be able to school/jump as we were pre-arthritis.

There are other options than injecting the joint, so don't give up just yet.
 

thedutchess

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I’d want shoes that eased the breakover as much as possible too if going that route.

Am I right in thinking he initially improved after the joint injection?
Was he tested with other hoof nerve blocks. I think we had to go back a second time for the coffin joint nerve block as the palmar one can interfere.
What sort of level of change did he have on X-ray?

We had a coffin joint djd diagnosis on the basis of blocks- nothing on X-ray. Got about 4-6 weeks benefit from injection and got foot balance much better in shoes but still lame.
came sound barefoot and suspect djd wasn’t the issue or the whole problem.
It is possible to transition with use of boots for sore horses but I think it depends on what the xrays looked like as they will compromise break over.
No the injection didn’t work, when he had the injection he was only lame in trot, 2 days later he was hopping lame in walk Emergency call out as thought maybe something else really wrong, apparently they can have swelling and after even though I did ask if he would be ok and was told he would be fine, that happened they took some fluid back out In case he had an infection that came back clear, when they come back out I hope there going to do something, as he’s worse off now than he was before :(
 

thedutchess

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Yes, mine has arthritis in pasterns and coffins, diagnosed in november. She's not had the joints injected but has not long had her second dose of tildren. There was also ligament involvement, so has had hyaluronic acid and cartophen, and is shod with rolled toes to aid with the breakover point - on vets instructions. She's now on a pretty strict rehab programme as advised by the vet, and seems to be doing well. She's sound, feels much more like her normal self (i.e. a menace) than pre-diagnosis and vet has said she should be able to school/jump as we were pre-arthritis.

There are other options than injecting the joint, so don't give up just yet.
If she didn’t have the injections what is Tildren? hyaluronic acid and cartophen
 

ester

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Tildren (and osphos) are systemic treatments used for arthritis (change the bone remodelling system stuff, I don't think it's entirely clear how that works totally yet!)
Cartrophen is a different systemic http://www.cartrophen.com/for-vets/what-is-cartrophen-vet/
Hyaluronic acid is a joint 'lubricant' and usually injected at the same time if you are using steroids. https://www.activepetlife.com/hyaluronic-acid-in-veterinary-medicine
Athrimid is another option that is fairly new and I know nothing about, other than it tends to be last line and has some success if nothing else works.
 

sbloom

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I posted on your other thread but do agree it may be worthwhile checking that the diagnosis is 100% correct. When Tildren came out I remember reading on the Ultimate Dressage BB a human orthopod saying she would never use it on her animals. Said enough for me, we really don't understand how it works and there is a good chance that it pulls bone from somewhere else too. I would want to gather as many educated opinions about it as possible before considering it.

If he was that sore barefoot then you need extra help, there are so many glue ons, pads, hoof boots etc that could get him through the crisis period, I to think ultimately barefoot is a really good route to consider, after my experiences years ago it's likely to be the only one I'd consider. He probably has multiple pathologies in his feet if he was that crippled straight away, and in many ways needs to go barefoot more than a horse that is sounds out of shoes. In the latter case the shoes are clearly doing no harm. But do read around, look at Rockley Farm on Exmoor, other barefoot resourses, and see what you think.
 
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