Coffin Joint Woes

Cliqmo

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Sorry if this ends up long, I would love any info / personal experience please as want to get an honest and clear picture of long term prognosis for my boy
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I took Boo (4yr 17hh Warmblood x Cob/ID type) to the vets for nerve blocks and xrays todays as he has had a grumbling lameness for about six weeks; during this time he has been intermittently sound, mildly lame, acutely lame and back again without rhyme or reason for the changes. He is not backed and came in lame from the field.

Today he was nerve blocked just below the fetlock but still showed lame so they 'prod tested' him and found the medial(sp?) block had not worked. A second go at this block (on the inside of the leg just below the fetlock) meant he trotted up sound.
(are you with me so far??)

Xrays showed a slightly long toe and a suggestion of ring bone to the outside (which they discounted as the problem because the nerve block on the outside had worked but he was still lame?) but no arthritis or navicular and only a very subtle "grainy" look to the coffin joint.

The vet thinks from the xrays it is likely to have been caused by a tweak or twist in the field and has recommend a coffin joint nerve block (have to go back next week) to confirm this is the site of the problem; he also advised that they will know by the amount of time it takes the block to work whether it is a joint or a soft tissue/ligament problem?

My question really is whether this is a problem that is fixable or just manageable? I have read the previous threads about various joint injections, supplements etc but can't quite fathom whether this is to rectify the problem or just to treat the symptoms?

Cookies for getting through this, any info would be massively appreciated
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silverbreeze

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I've not had any expeirence of this sort of thing but I have on 2 occasions had experience of the dreaded joint blocks and doom and gloom veterinary conclusions drawn from said blocks.
One of my horses I was told had pedal (sp) ostitis and had series of very painful surgical shoes which I stopped after 2 sets as they were causing hoim so much discomfort. We got to the bottom of it eventually and it was split heal bulbs that used to get grit in them and he would get sores (treated with a syringe and salt water) my boy carried on for another 5 years . he was an old man.
Second horse was diagnosed with rotated pedal bones through process of xrays and joint blocks, when he was 5 and I was told he wouldn't ever come back in to work again. He is now 16 and competes at foxhunter BSJA and is the most sound horse I have (touch wood) With the help of physio and other alternative therapies we came to the conslusion he had damaged/torn some muscles under his shoulder blade.
I am not saying this is defo the case for your horse but don't write him off completely on their sometimes overly scientific explaination. It's amazing what field rest can sort out (at a teenth of the price) and gentle rehab. I don't like the ideas of injections in horses so young tbh as I class them as a last resort unless the horse is obviously hopping lame. If he was mine I would stick him in a field all summer and see what happens next year.
Fingers crossed for you and hopefully it is another case of the doom and gloom merchants at work!!
Over the last six weeks have you tried to bring him back into work and that is when it gets worse or is this just field observations?
What was he doing when you noticed the problem and did it come on as hoping lameness or gradually get worse?
 

Darkly_Dreaming_Dex

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*also in NL*
Link to my post similar to your problem a year ago, inc videos of his movement:
http://www.horseandhound.co.uk/forums/showflat.php/Cat/0/Number/3011176/an/0/page/2
update to the above:
16.2hh 8yrs Jacob had arthroscopy surgery under GA on his coffin joint 4 weeks ago. He had intermittant lameness for 10 months that defied diagnosis. his xrays and scans were all clear but slightly fuzzy round the joint. His foot balance was declared excellent. He went hopping lame a month ago so was referred to vet hospital. The operation found a bone chip and cartilage was torn off the bone and they suspect it had been like that for a while
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They said its not unusual to have clear xrays with this level of damage, it might have shown under MRI but both the hospital & my vet felt its a lot of money for a "pretty picture with no solution"hence the investigative op. They removed the chip and damaged cartilage and four weeks on, he is still on box rest and about 3/10 lame. He is slowly getting sounder but it is a long process, we do not expect to ride him this year. We have purchased a project horse to allow Jacob as long as he needs to get well, he will never leave us i just want him pain free in the field, anything else is a bonus.
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Cliqmo

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Thank you for the info Silverbreeze, I fear the field option may be the only option as insurance doesn't cover vets fees and I really want to avoid spending all of my OHs hard earned wages on endless injections
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We will wait and see what the vets say first though
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Cliqmo

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Thanks for the info and video links Darkly_Dreaming_Dex. Did anything come from having his back/hind legs or feet investigated further? I'm particularly interested because my chap was very weak behind and is now lame on the front!!
 

Marchtime

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If your insurance doesn't cover vets fees then I'd turn away until next spring. The problem with coffin joint injuries is they are difficult to diagnose. Nerve blocks can narrow down the area and x-rays can provide some idea but aren't conclusive. The only conclusive diagnosis comes through MRI which is expensive and as the above poster points out doesn't provide a solution.
Jesper was originally diagnosed with coffin joint arthritis following x-rays and nerve blocks but joint injections failed to have much impact and so we pushed for an MRI. The MRI confirmed the arthritic changes were irrelevant and the lameness was caused by collateral ligament damage. The only treatment is rest. His prognosis was poor. He did return to light schooling and hacking after nine months off but sadly retired this spring a year after coming back in to work. He retired as his hind suspensory has become damaged again.
Interesting you mention about the hind legs. Jesper originally injured his hind suspensory aged 5yrs and it healed fine. He went lame in front at 8/9yrs old and then went lame behind again at 10yrs old. My vet believes because his left hind and right fore are both injured (diagonal pair) the injuries in essence aggravate one another.
Sorry for the essay!
 

Cliqmo

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Hi Marchtime and thanks for your post. It is with some amount of sadness that I acknowledge your experience, as I realise that this is exactly the predicament we could find ourselves in but with the unfortunate livery bills still hitting us for £150/month
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My OH is very patient and understanding with my varied and extensive horsey expenses but I'm not sure if it will stetch to £1500 on livery charges for a horse that is 'signed off sick' for 9mths
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I think I may have to give my (dairy farming) parents a ring to find out if they will take him
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although that isn't ideal either as it means a long pause in his handling/ground training
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Marchtime

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If it's any help I do believe we were unlucky. Whilst the vets at Liphook gave him a poor prognosis my vet was adament he could get him sound and return to dressage at elementary level. Sadly Jesper listened to the Liphook vets!
Whilst a long pause in your training might not be ideal I do believe that it sounds like the best option. I understand about livery bills, it's such a horrible dilemna.
As I see it there are two options (there are more but the two I think are viable are):
1) Try the joint injections and see whether these work. With some horses the effect is immediate and drastic, with others there's little response. You might be one of the lucky ones.
2) Turn away. You could do this before or after the joint injections.
I hope your story has a happy ending.
 

moodymare1987

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I took a friends horse to leahurst last year due to lameness. She was on holiday when his appointment was, so asked me to take him.
Anyway after all flexion tests, lunging nerve blocks in one day, they kept him for ten days. Turns out he went lame in his hing leg and his foreleg aswell.

They started work on his hing leg as that was the one he was referred for initially. After about 6 days they said he had an inflamed coffin joint. So had injected him with anti imflammoratories (sp) they then rang me to ask do they want to investigate the front leg. I consulted friend and agreed yeh. Anyway turns out they could not find anything wrong in his front leg, So had to bring the horse back after ten days at the vets. To go back in 4 weeks if still lame for a scan of the forelimbs.

Anyway took him back and he was as sound as a pound Bugger he is lol.
The winter was testing for us though, as he kept going lame and I use that lightly as not dog lame but defo not right. So had few days off to then be a goon when rode to go back lame. Was a very viscous circle. As vets advised to stick to walk and a bit of trot untill up to more work. Needless to say friend got disheartened, But I was adament come summer he will be fine.

Anyway shes riding him everyday walk trot canter like any other horse and he has been fine. it also helps he has turnout, our yard does not have winter turnout.
And he has been fine (touch wood) since.

Try not to think the worst. The vets thought allsorts when friends horse was at leahurst. I was ringing her everyday after they had rang me with daily updates. And I had to keep some info to myself as it would have scared life out of her. And vets did say depending on how he goes he may need another anti imflammatory. But its been a year next month and he hasnt needed one yet.

Sorry for the ramble, just wanted to explain what my friend went through.
 
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