DDFT injury of some kind - thoughts?

[pootleperkin]

So my boy was jumping 11 days ago and came up on three legs, lifting right fore.

Long story short, his pastern was very inflamed, mainly to the rear and his lameness manifested as toe dragging to start with. He was and is, still happy to put his full weight on it, and will rest his hind legs.

He was X-rayed at home clear and put on box rest. Over the first weekend, he improved a lot to the point he wasn't toe dragging any more and the swelling reduced around the pastern.

He was scanned a week ago Monday, and no tears etc could be found, but the DDFT did look enlarged in comparison to the clean leg. Vet suggested that as there seemed to be a lot of oedema, it might be tendon sheath inflammation, although there was no swelling above the pastern at all.
After a further week of box rest he is no better, although he did seem improved, certainly in terms of swelling at the back of the pastern, over the weekend. The front of the pastern had also come down tremendously, but today after a very short walk out, it is enlarged again so that a difference in size in comparison to the other foot is visible again.

He was on bute until 3 days ago and is being hosed for 20 mins twice a day, has a Bonner Ice Bandage put on twice a day and is stable bandaged over night. I was putting Ice Tight on, but think I will stop that. I walked him today as I was concerned about circulation not being sufficient for tendon healing.

Vet has just been out and agrees he is no better, in fact could be a little more lame. He has advised taking him in to the surgery to re-examine, including more x-rays and scans. Vet said walking out could have caused the increase in swelling seen today, but equally, after this long on box rest, such a short slow walk (around the village green) shouldn't have had such an effect if healing (of whatever?) were taking place.

I'm just wondering if anyone has had a similar experience or any ideas as to what could be going on? I'm rather anxious as it was looking as if it was a minor injury that would come right relatively quickly with rest but now it's not looking so good and we were supposed to be going to HOYS

 

[pootleperkin]

No one?

 

[be positive]

I think I would want nerve blocks next to find where the main issue is, if it is just the pastern you can then rescan, if the foot is implicated, which it may well be given the way the lameness has developed, an MRI would be required to show any tendon or ligament damage inside, assuming that it has already been xrayed.

The fact the bute was stopped 3 days ago is most likely why he has gone backwards, the anti inflammatory effect has worn off so it is swelling up again.

 

[pootleperkin]

That's good, as that is what is happening next - he's going to be nerve blocked on wed/thur. Hopefully it isn't the foot. This is a completely new injury, but we have been to Edinburgh Dick before for MRI..... Foot hasn't been x-rayed yet.

I would have thought the bute effect would have relinquished sooner than 3 days, but I'm no expert. Thanks be positive.

 

[eventing_2012]

My horse went very lame one day when I was competing which was very out of the blue and I noticed a swelling on his pastern when we got back to the lorry. THe vet came out to a lameness work up and look at him, he was sound in walk and trot on a straight line on a hard surface and on the lunge on the soft but lame on a cirlcle on hard. He had scans and they showed damage to the oblique sesamoidian ligament. maybe worth having yours scanned as sounds like it could be similar.

 

[pootleperkin]

Full work up done yesterday - definite lameness in the distal limb (pastern joint). X-rays all clear, including pedal bone and scans all look clear in terms of tendons, ligaments and tendon sheaths - there is a tiny question over the annular ligament - vet not certain, but going to send scans away to Edinburgh for second opinion, but no oedema in the tendon sheath which doesn't really compute if a ligament tear. There is a HUGE amount of soft tissue swelling all around the pastern, probably double what there was on the last scan a week ago. So, at the minute, the diagnosis is essentially a sprain. He's back on bute, continuing to cold hose and bonner bandage plus stable bandage on his box rest.