Coffin Joint injury - any advice?

[Annagain]

My horse has now been diagnosed with some sort of coffin joint injury in his right fore (can't be sure exactly what without an MRI). This is after being lame on his left fore for 6 weeks which was diagnosed as bruising. He is almost sound on his left fore now but not quite 100%. Vet thinks he has overcompensated and damaged the other foot although there are some conformation issues as well. X-rays of both feet have revealed no real problems, no sign of navicular, ringbone etc so vet is confident he should get back to normal after this.

He has had steroid & hyaluronic acid injected into the joint and is now on 6 weeks field rest and a course of cartrophen (4 injections over 4 weeks) before bringing back into work. Vet has also recommended raised heels although he doesn't need them until he is next shod as he'll be out of work until then. He seems better already (is this possible in 4 days?) although he hasn't been out of field onto concrete where theproblem was most evident.

I was just wondering if anybody had some experience of this sort of thing, any advice on getting him/keeping him sound or just some words of wisdom please?

 

[Kal]

Just bring him back quite slowly. After mine had the injections because of coffin joint issues, i started hacking him out slowly, only walking to strengthen up his legs. Do a lot of strengthening work and he may need shoeing more than before. Don't lunge on tight circles for very long either.

Hope this helps a little

 

[misst]

If the joint is just inflamed then the joint injection probably helped.
Without MRI you are right, you cannot tell if he has soft tissue injury as well. If he does then he will probably need much longer off work and the prognosis is poorer - if you are insured or can afford it I would get the MRI done and a specialist vet opinion. If he has soft tissue damage it will be made worse by not resting him - he may not be very lame on it and the injection and temporary rest may well show a short term improvement. In the end it is best to know what you are dealing with.

 

[Annagain]

The thing with the MRI is that he'll need to go to Newmarket for it - a 5 hour journey one way. My vet has said it will only really help with prognosis rather than treatment as we have already given him the only treatments available. I'm just not sure it's worth putting a pretty insecure, nappy horse who doesn't cope with being away from home very well through that just to know whether his prognosis is good or bad. If it was closer to home I wouldn't hesitate but it seems a very big upset to cause him for not a huge amount of gain other than knowing what time could well tell us anyway. He's sound in the field so isn't suffering.

 

[misst]

I understand exactly what you mean as have been there and it took us 4 hours!

The only thing is that if he does have a soft tissue problem that you don't know about then you may ruin his chances (small though they may be) of recovery by not resting him for long enough. If it is a collateral ligament problem then the usual treatment is complete rest for several months followed by small paddock turnout followed by very very careful rehab.

I understand what your vet is saying and agree to a point but being sound in the field does not mean he is ready to rehab.

Madhector has a young horse with this problem at the moment and he is on 6 months complete rest (Sue Dyson at New Market was her vet) with a fair prognosis. If he wasn't rested and diagnosed then he would probably not have stood a chance. He was never "lame" just "not right".

I have lost a horse to this problem as well as having my daughters horse retired early due to it so if you can have a better outcome than me that would be so good.

Good luck.

 

[Annagain]

Thanks, my vet didn't quite put it in those terms! When you say complete rest do you mean box rest or small paddock. I am tempted to turn him away for six months anyway as my friend is pregnant so I have her horse to ride for the foreseeable future. It might be best for both of us.

 

[misst]

Search on Madhectors post as she is very familiar with this but her youngster is on complete box rest for 6 months.

Our lad did 7 months and was worse at the end - BUT - this was several years ago and he was misdiagnosed and allowed turnout when he went lame instead of immediate box rest. My daughter was also advised to "work him through it" - she didn't though.

The 11 yo has done much better and probably is sound in front - sadly he had redone his hind suspensories - bl**dy animal.

I don't want to worry you and you have to do what is best for you but I know that a clear diagnosis can help with the question of how to proceed. Also if insurance will pay then you need to do it sooner rather than later.

There are lots of people on here who have had similar problems and those that do well seem to be those who have had a clear diagnosis and extended rest with additional shockwave/irap/stem cell/ etc etc.

I am not a vet so please don't just take my experience as gospel - Sue Dyson is lovely and would perhaps advise you and your vet of the next step? Just a thought but she is the "woman to see" for this.