Curious

alsxx

alsxx

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I've been pondering about what is the best way to go about treating 'lameness'.

This has come about from me thinking (dangerous I know
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) about my own mare and the saga with her, but also other horses on our yard that are treated by the same vet.

I got a second opinion on my horse when he lameness on her LH kept getting worse and current vet told me to keep going with the conservative management route (they had diagnosed PSD).

My second opinion vet said she was lame in all 4 legs, and had DJD in no less than 4 joints (1 in each leg) as well as heel pain (front feet) and a tendon sheath problem. She received 5 steroid injections (4 joints plus tendon sheath) which seemed to make her better, but now we are virtually back to where we started (heel pain, tendon sheath and certanily the R hock). My vet wanted to do more to her, but I said no, enough's enough and she goes out to grass, where she stays, or, hopefully makes a recovery in her own time. She is quite happy at grass, and 'field sound'.

During her saga she was seen by another vet at the request of my insurers (who still havent paid up) and both this vet (a very well known one I might add!) and insurers dont believe she could possibly have had half the things wrong with her that my vet said she had. At the time she was seen by this vet, the steriods had had a positive effect and so she was only lame in front from the heel pain and from the tendon sheath behind which was there their claim came from. Make of that what you will.

I'm curious because other horses on our yard have been investigated by this same vet and have also had a long list of things wrong with them, and months of treatment/box rest - only things such as 'sore joints' etc being diagnosed.....One such horse was not even 'lame', a 4 year old just broken, but said vet did a full workup because she didn't think his stride length infront was as it should be. He was MRI'd, the lot, and if I recall had about 4 joints medicated also, 7 months later he is finally back in work.

I am starting to think that (sometimes I'm not sure what I think!!) maybe I should have chucked my mare in a field last year and seen what happened. What do other people think, do you investigate to the bitter end and find every tiny little thing wrong with a horse, or do you do something different?
 
Vets are governed by a rule of ethics, that they can't issue and charge for treatment if treatment is not considered in the horses best interest, or something to that effect anyway.

However, I have to say that a lot more diagnostic treatments are carried out these days. This could be because vets are better informed than they used to be, and have better facilties and equipment to be able to make diagnosis on animals, although this will be costly. Or it could be that some vets have had to upgrade to a larger premises and foudn that the best way of paying for this is to make sure the animal in question has every single test flung at it in order to pay for their moving costs and upgrade of premises. I guess it depends how cynical you are!!
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Well, I used to trust this vet a lot, now I am cynical you might say....I do feel that I learnt a lot.

But said vet is a one man band....

But thats besides the point, I'm curious to know what people's thoughts are if it was your horse? What would you have done?
 
Its difficult. In the 'olden days' they would have just turned a horse away and wait to see if it would improve. But that was probably because there was nothing else that could be done for it, things were very limited then in terms of diagnostic tools. To be honest these 'experts and professionals' have us over a barrel. We could be told any old thing by unscroupulous people and we would be inclined to believe what they say. Take saddle fitters, isn't it weird how none of the second hand saddles they bring along to your horse to try on your horse fit, but the most expensive saddle always does?? Cynical, or am I correct? Who knows. But you would rather take the word of a saddle fitter over your own limited experience wouldn't you? I know I would, so there you have it, they know this and I am certain some use it to their advantage and to line their pockets!!
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I really don't know what I would have done in your position. If the insurance is paying I'd fling every test and diagnostic tool at my horse. We all have different reasons for having a horse. Some people have one for company and some to just hack out, whereas I want to compete on mine so I kinda feel that if we are not out competiting I am wasting my money a little bit in keeping him in food. Having said that I don't know if he could never be ridden again if I could bear to have him PTS, I begged the consultant at the hospital to let me keep my previous horse as a field ornament when told he could never be ridden again even though I knew it was totally the wrong thing to do for me as I wanted to ride and compete. As it so happened he was too dangerous to keep alive and had to be PTS.
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Whether that was the consultant being kind to me, or whether it was the truth I am not sure, I have a sneaky suspicion it was the first which is fine by me as it was probably the right decision to make, but one I coudn't probably have made. Would I have ended up resenting a horse I couldn't ride and not having the money to have a second? You betcha I would have and I make no apologies for it. I work hard to keep my horse and compete and that is all I want to do, I go without clothes/parties/holidays to do this.

Sorry to take over the post but I find this point very interesting. It is a very interesting point you have raised, I will be interested to see other peoples view points.
 
Interesting - having had a horse in the past diagnosed with navicular. Eventually after my own vet (original vet was from the school where my daughter had taken him) said it wasn't navicular and referred him to a 3rd vet in newmarket who diagnosed him with collateral ligament rupture after MRI.
All this took several months and the horse got noticably more lame as time went on.
I have no issues with the final diagnosis and report which was by Sue Dyson at Newmarket.

Sorry that was very long
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However I know that if you go somewhere like that the chances are they will discover lots of things wrong. As a human nurse I know that xrays can show arthritis but a person can be unaware and not in pain from this - it can be an incidental finding whilst looking for something else. Horses cannot tell you what does and doesn't hurt so it is difficult to know where the problem stems from.

I honestly believe there are a lot of lame horses out there. Having had another one with chronic problems (PSD, SI probs and pedal bone probs leading to collateral ligament damage) I seem to spot a lot of lame horses! These are often competing and seem fairly (not always but usually) happy and willing to continue in their work. There are a couple at our yard that I would consider lame but the owner says "they always go like that" - where do you draw the line?

There have been a lot of posts about this in C.R. and the feeling seems to be if the horse is happy and has low grade/chronic problems then people tend to ignore them. Both of mine had behavoural issues associated with pain so it was obvious they needed to rest/retire/pts.

I think the "top" vets will always find something as technology improves and overall as applecart says they have a duty to do things in the best interests of the animal. As a paranoid owner I like to investigate everything and seems to have large bills and problems for my trouble. Lots of others would not have bothered -but each to their own.

Interestingly my vet says that if a horse is under 8 chuck it in a field and it may well get better unaided after a year. If it is over 8 it will probably come back worse than it went out. I cannot comment on this to be honest but I do trust him.
 
I am going through this kind of thing at the moment. I bought my horse last year out of training and he moved awfully. I got him fitter and he did tons and tons of hill work and ended up going pretty well. He was hunted until the end of February when he slipped in the field. He hasn't been right since. He's been to the vets about 10 times and it was only yesterday he was diagnosed with tears to the supraspinous ligament in his back as well as spavin in both hocks (which we knew about). It took a bloody long time to get to that conclusion (vets bills pretty huge but thankfully he's insured). He's to be turned away after having some new exciting stem cell type of thing done to his back and tildren and hocks remedicated - in the olden days he would have been ridden regardless. Now the vets are saying at least 5/6 months off (which to me means tll the end of the hunting season in March...!!). Surely they could have diagnosed that all before and we would have been three months further down the line with his treatment? He is 8. I'm sure if I was a little less experienced he would go on almost fine for years but I can't ride a horse that I know is in pain.

I feel as though the vets have taken far longer than they needed to get the diagnosis correct. Very frustrating!!
 
I'm glad I've started an interesting post then....probably a first!!

I was left with the impression by the first vet that my mare wasn't really worth bothering with, hence why I got a second opinion. She was 5 at the time, was schooling sweetly, and whilst only 14.1hh, I had plans to do some BD and maybe some BE. I'd had her since a foal and I will keep her for her life. When I got a second opinion, that vet was very much 'they weren't interested because she is a pony'....I admit I was swayed (but as I said I have learnt a lot).

Yes she was insured, and a claim had been accepted for the original problem, so money wasn't an issue...then. It is now because there are a lot of people squabbling over my case and I am the one left out of pocket and with no option to do anything else with her even if I wanted to.

Interestingly, there were no changes on x-ray. Nor were there any on the x-rays done by the RVC (at insurers request) 4 months after the first lot. She has been MRI'd and although she had some minor changes, no one has said 'thats your problem', although the vet at Bell Equine that did the MRI did say possibly early stage nav, but none of the other 3 vets who have seen the scans/report agree/confirm with this. I dont actually have a clue why her heels hurt!!!!!!!

I think at the time, I wanted to do my best and give her every chance to 'come right', and as others have said, with all the diagnostics and posibilities there are now, plus the insurance to fall back on,why not?

In hindsight, my mares original lameness was down to the tendon sheath, but I dont know if all the meddling has sparked these other problems? If she even has them, which appears to be quite debateable (sp!) depending who you talk to!

But I am certainly starting to think along the lines of 'treating the obvious first'. When my new horse went lame the first week I had him, I got a different vet out, who treated for the cellulitis he had. I did this because I am 99% sure the vet I used as a second opinion on my mare would have found every tiny little thing wrong with him.
 
Interesting point raised by someone above, in that where do you draw the line? The vet I used as a second opinion was of the opinion that if a horse is say stiffer on one rein, its lame. No question.

I believe every horse is slightly one-sided, so when do you decide that your horse is being one sided, or lame??????????????
 
Funnily enough my boss (not horsey at all) was talking to me today about the "magic" man as he is called down here who can walk into a stable and tell you basically what is wrong with your horse by looking at its confirmation and looking at the horse as a whole as opposed to the vets who are great at finding all sorts of little problems and don't look at the horse as a whole.

The other things may exist but if they are not causing a huge problem then surely best to leave well alone I feel. If it ain't broke don't fix it. I sometimes wish I'd never said anything to the vets and just turned the horse away.
 
A very interesting thread .I am third generation 'horsey' and going back to when I was a child/teenager there was no insurance for vets bills just third party risks.If a horse seemed 'wrong' we turned it away for a rest sometimes we would stable a horse if it was felt that would help .There was no 'dymanic intervention .More often the horses came right with tlc and rest.
Sometimes I wonder if insurance has driven it all .People just couldn't afford to pay for all this tests and treatments and with no vets cover the vets fees were paid by the owner .With insurance suddenly the sky is the limit.
I have a mare who was slightly lame .I fetched the vet loads of tests and treatment later she is actually worse than when it started plus X rays have reveiled a 'problem' we didn't even know about and that wasn't causing any symptoms.
With the vets agreement I have now decided on specialst shoeing pain relief and I am turning her away for a couple of months .I feel she has been through enough and I want to give her time to settle down from all the 'interventions' just a few months enjoying the grass fetched in twice a day groomed and cared for but no more injections and hammering her foot about.
I sometimes feel 'we have the technology' .R and R ,and TLC have a part to play.
 
I think you are right in that insurance is a big driver. I remember it certainly was with me, I remember thinking, 'I only have a year', and I couldn't have afforded it without the insurance money.

It has all been a big learning curve for me really, as at 24 I've been lucky enough to never have a lame horse until now in all the years we've had horses, which is as far back as I can remember (unless you count a tendon and a horse doing the splits in the field, but both were quite 'obvious' to fix). I probably should have listened to my mum who reckoned she should be turned out and left for 6 months, but it was the insurance clock that made me ignore her good, old fashioned advice!
 
alsxx, I completely agree with your last post especially:

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[/ QUOTE ] I probably should have listened to my mum who reckoned she should be turned out and left for 6 months, but it was the insurance clock that made me ignore her good, old fashioned advice! [ QUOTE ]


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Same thing with my horse, when diagnostics & treatment are so expensive, and you only have a year for the insurance cover, you can make hasty decisions where once you would have turned away to see what happened. My horse had surgery for KS, in retrospect I wish I had spent more time investigating non-surgical treatments (though we had tried steroid injections to no effect) or given him time off, as the surgery ended up causing no end of problems. I do think vets (particularly the big equine specialists) love their fancy diagnostic tools and want to e.g. do a gamma scan even if the situation doesn't call for it. However in the end we love our horses and want to do the best for them so have to trust the professionals to help.
 
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I think you are right in that insurance is a big driver. I remember it certainly was with me, I remember thinking, 'I only have a year', and I couldn't have afforded it without the insurance money.

It has all been a big learning curve for me really, as at 24 I've been lucky enough to never have a lame horse until now in all the years we've had horses, which is as far back as I can remember (unless you count a tendon and a horse doing the splits in the field, but both were quite 'obvious' to fix). I probably should have listened to my mum who reckoned she should be turned out and left for 6 months, but it was the insurance clock that made me ignore her good, old fashioned advice!

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I'm a bit in the same boat as you, at 27 (and having had horses "forever" we have been really lucky in that we've never had a horse or pony with a mysterious lameness. We have had a punctured fetlock joint, and 2 very old ponies with arthritis, but nothing that wasn't obvious.

I'm another advocate of time, rest and TLC, sometimes I think we forget that horses weren't designed to be ridden, jumped or do half pass!
 
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