Dilema - To scan or not to scan?

[chasingmytail]

Our 16 yr old medium weight cob, never sick or sorry, has developed mild lameness. We thought it was in the near fore as she felt stiff and felt short. Had the vet out who diagnosed lameness in both hind legs and was fairly sure it was arthritis. So took her into the surgery for nerve blocking/x rays. The resident hospital vet, after examining her/trot up/lunging diagnosed 1/10 lameness in near fore and 2-3/10 lameness in near hind - both hinds failed flexion test. Started nerve blocking front leg and first block located problem in the foot. At this point no further investigation into the foot has taken place. Nerve blocked near hind up to the hock without locating problem. The vet has stated the problem lies higher up but doesn't know where. She has suggested a bone scan. So our mare is now on 2 weeks box rest with bute.

The dilema is the insurers won't settle the claim without a diagnosis and we can't get a diagnosis without the bone scan (which they have approved). BUT how do we know that the bone scan will provide a definitive diagnosis. If it doesn't we will end up paying for everything - vets fees, bone scan, transportation (200 miles round trip).

The vet also said "you never know, after 2 weeks box rest she might be sound". But that's not very helpful because we won't know the cause or whether it will occur again.

Any advice?

 

[Michen]

I got very diagnostic happy with my TB for the pure reason that I wanted a full picture of him and to make sure I wasn't wasting all my time, effort and emotion into fixing his main problem (feet) to then be screwed by something further down the line.

Personally I'd ignore the forelimb problem for now but if you can afford it maybe get some x rays done. Could possibly be something as simple as a bruise? Bone scans are great but can also show a lot of red herrings. You can be almost certain the bone scan will find SOMETHING somewhere so I wouldn't worry about the insurance not paying. If problem is not hocks then likely to be SI? Have you had a physio look at her, could even just be she is sore somewhere and is compensating thus looking lame behind?

 

[chasingmytail]

I agree re the foot. No, we haven't had a physio to look at her. It's an absolute minefield and we don't have money to burn. We're certainly not going to rush into anything without a lot of consideration. Thank you for your reply.

 

[Michen]

I agree re the foot. No, we haven't had a physio to look at her. It's an absolute minefield and we don't have money to burn. We're certainly not going to rush into anything without a lot of consideration. Thank you for your reply.

No worries I am far from an expert, others on here will be able to give you better advice. I would say though... how many horses at 16 are sound on a hard circle anyway. Not many I bet.

 

[gunnergundog]

The vet nerve blocked as far as the hock without the horse proving positive; he thinks the problem is higher.....so did he block the stifles and the SI? If so, what were the results? If not, why not?

 

[chasingmytail]

The vet nerve blocked as far as the hock without the horse proving positive; he thinks the problem is higher.....so did he block the stifles and the SI? If so, what were the results? If not, why not?

She only blocked 1 hind leg up to the hock, don't know why she didn't block the other hind which had also failed the flexion text. Didn't explain why she didn't block any higher, except to say that the problem was higher, e.g. stifle, pelvis, SI and that our horse was getting fed up of needles. Also, didn't suggest ultra sound - possibly because it's not always useful in cob types?? One thinks of so many questions after the event!! I do need to speak with the vet again to help in our decision making.

 

[Birker2020]

IYou can be almost certain the bone scan will find SOMETHING somewhere so I wouldn't worry about the insurance not paying. If problem is not hocks then likely to be SI? Have you had a physio look at her, could even just be she is sore somewhere and is compensating thus looking lame behind?

I agree with this. I get the feeling that a lot of people don't rate these unless a scan is done for something where an area of the body is highly suspected of having problems. Its a bit like xraying 100 horses aged 10+. I am sure you would find at least 50% have undiagnosed issues which although may not be causing a problem now, will be in a few years time. Bit of a misnomer really.