Coffin lameness MRI findings and whats next

[Louisewere]

My mare was lame in the spring - front right. Vets blocked and found it was coming from foot. Decided to send her for MRI as insured. The MRI report was as follows:

In out opinion these MR images have ruled out the presence of major injury to the deep digital flexor
tendon and collateral ligaments of the distal interphalangeal joint. The most significant features
represent some laminar injury at the lateral palmar process of the distal phalanx and mild synovitis of
the distal interphalangeal joint. This combination of changes could be managed with a combination of
corrective farriery and intra-articular medication. It should be considered that there are many causes
of foot lameness which result in little change in MRI scans including lameness due to solar bruising,
inflammation of the mural or solar laminae, under-running of the heels or digital cushion pain.

So far she has remedial showing - heart bars and pads. Also had coffin joint medicated but didn't include steroids as she is always bit cresty, although not obese( probably EMS) so decided it wasn't worth Laminitis risk.

Shes come back into work and still isn't sound. Can go nicely on right rein but in left rein she is clearly uncomfortable. Not sure where to go now, I will call vet again, to discuss the use of steroids, but just wondered if anyone had anything similar and what actually worked, if anything at all!

 

[Red-1]

I believe some time without shoes, with a barefoot diet and barefoot rehab plan is the way to help.

A shoe reduces that amount of function in the foot, and bar shoes do this even more. I would take shoes off when the land is soft, provide boots/easy surface as necessary and allow the feet to first of all relax then build up.

A barefoot horse's foot is different to one that has had remedial shoes on. It will take care and attention, especially at first, but it is my experience that the foot regains function, grows, and becomes strong.

I believe that a few months a year without shoes is a good thing. It is like a reset. Mine come off this week (hopefully) to be a month off, walking in hand and ground work, then riding, back to full work at Xmas. He is sound, although his feet did crack with the hot summer, there is no need to be barefoot, I just think it is healthy long term.

With other horses, they have got as far as reasonable hacks and competing BD/BS before I have re-shod. I found that every year I took them off, they could go longer before the work rate increased enough that I would shoe up again.

 

[Highmileagecob]

Read all you can about hoof rehabilitation, and find yourself a recommended farrier who will work with you to implement changes in the hoof. Good information abounds from the likes of Dr Robert Bowker, Jamie Jackson, Pete Ramey, Rockley Farm et al. And yes - get the shoes off as soon as the remedial shoes have done their job.

 

[AudreyB]

On august 6th my horse started being lame; on the left hand, only on hard ground. After a few days rest to see of it went away naturally or wasn’t an abcess, and a visit from the vet who concluded it was in the coffin but x rays were good, we took him for an MRI son august 24th
The result was
- sole bruising due to thin soles / flat feet
- light Synovitis and very mild capsulitis
- and the beginning of very light arthritis in his fetlock - not explaining the lameness but to put in check

on 30/08 a new farrier came because the previous one wasn’t managing his feet well enough. He had to rule out going without shoes because his feet were too flat and he was too sore. He had to put on leather plaques and silicone.
On 31/08 we did a tildren injection for the arthritis and injections in the area of the capsulitis and Synovitis
-> we did 2 weeks rest, just walking on hard ground, hacking around - between 20 to 30 minutes per day. Then showering his legs/hooves

tomorrow we will test him and see of this was enough or if he needs more help to stop the inflammation. The vet said that we were definitely not out of options but since it was a mild inflammation and the cartilage wasnt impacted she hadn’t used “the big guns”.

if he’s not we will probably have to do PRP or IRAP.

I hope this helps ! Have you had a second opinion yet ? Sometimes other vets bring in new perspective… take care.

 

[ester]

Shoes off at this stage is a no brainer to me

 

[PinkvSantaboots]

Agree shoes off and rest then do a proper rehab heart bars and pads are not a long term solution in many cases.

 

[Goldenstar]

I would get the horse on a diet so you can settle the situation with steroids that would be my priority
Also the lighter you get her the easier it is too manage issues like this
Some do well shod some so better without and doing the whole barefoot rehab thing the difficulty is working out which works best for that horse .

Have they asked you to put her on box rest ?

 

[Louisewere]

Thanks everyone
I will consider having shoes off but my farrier says it is not the right thing for my horse right now, her feet are too flat.
She’s not on box rest and has been never been throughout the lameness.
Talking with vet now about doing a blood test to assess lami risk to see if steroids are an option. If not, vet mentioned a product called Anthramid (spelling?!) which night work.
I probably am heavier at the moment (66kg) so you’re right about me aiming to be lighter to try and help.

 

[sbloom]

Have a look at the work of Progressive Equine Services on Facebook to see a whole new approach to shoeing and why traditional "remedial" shoeing may not be helping (I stress this is general information, not sending you there to say use their protocol for your horse, but they have a great slant on modern shoeing). I'm a big barefoot fan too, flat feet often need the rehab the most, and many can be comfortable with boots on. This is likely outside of your farrier's expertise so it is up to you to read around and decide whose advice to take.

The diet comment was aimed at the horse/pony, to reduce that lammi risk, and enable use of steroids if indicated, but that is short term help only anyway.

Long term yes a lighter rider will only help, but a horse lighter on its forehand will punish its front feet less. Have a look at some of the new online resources looking at posture, lifting the thoracic sling for example - some groundwork aimed at this should be part of your rehab but is unlikely to be suggested by vet or farrier.