Don't know what to do?

[Bri]

Insurance are refusing to tell us whether they will pay for horse to have bone-scans. However they have told us if we go ahead and do it without their authorisation then they don't have to cover it.

Horse is in pain and seems to be getting worse. Not unbearably so, he's still happy to eat but is very quiet and snappy. Vet told YO he thinks horse should be PTS because of his background

Don't know what to do...sobbed for hours earlier when YO told me what vet said. Need some reassurance or advice or something

 

[kildalton]

Oh hun .I'm so sorry. Mega hugs, Lucie.X

 

[Clodagh]

Is this the lovely skewbald in your avatar? (Not that it matters either way). I am so sorry for you.

 

[Bri]

Thank you. And yes it is.

 

[kalasadi]

Most insurance companies now will only pay 50% towards a bone scan anyway. & a bone scan can only sometimes show the 'tell tale' problem. I have known many horses having a bone scan and the vets are still stuck afterwards as the bone scan showed nothing!

The decision can only be yours and should not be influenced by a YO.

Pain management can be in place for your horse now to make life comfortable until the bone scan.

What has your vet diagnosed and the prognosis? & why does the vet say the 'background' is reason enough to pts?

My ex racer broke his leg racing and later on did a tendon. He has with me done a tendon, both front suspensories, has navicular & then got leuko cytoclastic vastilitus!! We are collecting exclusions every year!

Only you can make the decision as you know your horse!

 

[Bri]

Insurance has said that it's their policy to cover the cost, but it depends on the circumstances of each individual case.

Vet has no diagnosis - but we know it's in his foot and somewhere else in his hind quarters. He's incredibly nervous and nerve blocking is impossible. Horse is becoming a little more crazy every time the vet visits, he thinks bone scan is the only thing left that won't 'ruin' my horse psychologically. He used to be a gypsy trotter and was very badly treated. Vet thinks we have no idea what they did to him, and from the symptoms its likely to be something pretty bad. Due to my horses nature he said if it was his horse he's have it PTS as he is dangerous.

I don't know what to do. Very confused, and emotional

 

[Lucy_Ally]

Sorry, I don't seem to have followed your story if you have been posting it on here. Why does the vet want to do a bone scan? Does he suspect boney changes (for example arthritic changes) or is he really running out of ideas as to the root cause of the lameness? A bone scan will only give you an indication of areas of high bone turnover (i.e where the bone is building more bone in response to stresses/disease) and whilst valuable to determine the precise location of a "hotspot" other (cheaper) diagnostic tools are equally valid for arthritic changes such as x-rays. If your vet is using the bone scan to confirm a condition either way which will lead to a definitive treatment being decided upon then I would say go for it, however if he is really unsure of the cause of the lameness and just stabbing in the dark and your insurance company are arsey then I can't see how mch good it will do you (apart from leave a large hole in your wallet!)

My advice:

- Talk to your vet, find out what they hope to achieve from a bone scan, will it lead to a definitive diagnosis
- Ensure your horse is kept comfortable on painkillers, the vet may think that he should be pts but that is your choice and if you feel more can be done you either need to change vet or be insistent with this one that Sid is made as pain-free as possible
- If your vet truely believes he should be pts then it can't be due to "his past" it should be based on the prognosis of future soundness and his quality of life

Don't be frightened to ask your vet lots of questions, good luck I hope it gets sorted for you.

xx

 

[Lucy_Ally]

Has he had x-rays?

 

[Bri]

Multiple x rays of hoof, fetlock, hock and stifle. All showing no obvious changes.

There is no swelling or heat so vet thinks it is unlikely to be tendons.
He either is unable or doesn't want to offer a possible diagnosis. He is a great vet, he's looked after our horses for ten years. I think part of the problem being he still sees me as a little girl, I thought he was being blunt with me but turns out it seems he's been trying to protect me from the harsh reality.

Bone scan/mri is literally the last option for the poor lad as he is so nervous. Literally impossible to do anything else with him,and what has been done already has seriously affected his behaviour. He is going to newmarket where he will have a full lameness investigation, so obviously if they find something beforehand then he wont need mri/bone scan.

He seems to swing up and down. This morning he could hardly walk when he came in and was swinging his leg right out and placing it down very short. Some days you could hardly even tell he was lame...Just so confused

 

[Clodagh]

My brother-in-laws horse has just had an MRI at Newmarket. After 2 years of intermittent but major lameness. It has been diagnosed as a damaged ligament to the pedal bone, he had the nerve to that bit cut yesterday.
Just out of interest.

 

[Bri]

Oh right...what's the long term diagnosis for him?

The thing is it could quite literally be any one of thousands of things. I think the vet won't tell me what it could be, because he doesn't want me to worry unecessarily. He did mention to YO he thought it could be deep digital flexors but really hoped it wasn't.

 

[kalasadi]

swelling and heat does not always happen in tendons! mine changed the vet books when he did his deep digitalflexor-no swelling, no lameness and no heat!

I would pause on the bone scan and send your neddy to Andy Bathe at Rossdales at newmarket. They will be able to assess and diagnose your neddy with you there & then they will be able to tell you whether or not bone scan is necessary!

I would certainly want soft tissue damage ruled out before I went down the expensive route of a bone scan.

 

[Bri]

He's supposed to be going to AHT in Newmarket....is soft tissue not done with an mri?? They suggested that would be last step as it was most expensive?

 

[ruscara]

I can't offer you any advice, as I have never had to deal with anything like this, but you are in the middle of a nightmare at the moment, and I just wanted to say Sorry

I do hope things work out for you and your poor horse. Insurance companies seem just to make everything worse very often. Nightmare.

 

[kalasadi]

You said your horse was going for a bone scan (correct name cintography) which is where they give your horse a dose of radiation and then the bones will show up.

An MRI is totally different and cuts through (on computer) each layer of the horse showing any changes in soft tissue/muscle.

From what you have said the horse has good days/bad days sounds very much like suspensory ligaments or tendon/other ligament problems. Andy Bathe @ rossdales has perfected the diagnosis and denervectomy operation on the suspensories and the horses return to full work around 6 months later-totally lame free!

 

[foraday]

I followed your post on complaint on soapbox earlier today.
Sorry about your horse but has your vet really done any ultrasound scans on the horse at all?

although the scans they do a quite crude compared to an mri they will show any holes in tendons/ligaments

Ditto kalasadi here-have taken many a horse to rossdales and seen some amazing results.

I do hope you can get to the bottom of your boys problems and get him on the orad to recovery asap

 

[Bri]

Nope none whatsoever.

Don't know whether it's because he thinks they're unessecary or because he doesn't want to because of the horse's attitude.

Sorry to clarify, he is going newmarket to have a full lameness investigation with bone scan, and then an mri if it's necessary. Although we may well cancel the appointment now.

Will ask vet about rossdales, I have pretty much been taking his word for it, being as he's the expert, but maybe I should start being a little more pro-active myself now!

 

[Clodagh]

I'm sure it was Rossdales that Penrose went to. They have just got an MRI and B-in-L got a discounted scan as P was such a mystery to them.
The nerve cutting apparently can be done to such a precise area that the chances are really good. (Penrose is a hunter).
I appreciate that yours could be anything, but it was only the MRI that showed any problems, but I think they are incredibly expensive, is that right??

 

[airedale]

My vet in Surrey does bone scans so wouldn't need to be sent to Newmarket for that - and my horse had one done to diagnose high hind leg lameness - turned out to be fractured pelvis.

He's fine now and that was 8 years ago.

Now Greyfriars at G'ford - Dietrich von Swinitz - does thermal scanning to diagnose problems - particularly backs - but again that is non invasive and in Surrey (but it's a few years ago since I saw his paper on this so he may have moved on). That is another option and cheaper than either MRI or bone scan.

Sounds to me like your horse has a combination of two things together - hence the lack of an 'easy' diagnosis.

Your heart is telling you to have further tests done. Have you thought of going to Potters Bar instead of N'market? Might be cheaper and keep the Ins. Co. happier.
Your horses past is against him though - that sort of horse is hammered at high spped on tarmac roads with no consideration. Damage is bound to follow from that and on those grounds the diagnosis, if you go down that route, may not be a good long term happy ending.

Is the horse really dangerous or is he just downright scared and fed up with being poked and prodded ? If he is dangerous, seriously, then perhaps the money on diagnosis is not justified. If he's merely scared and you are the only person that can answer that then I believe every animal deserves a chance.

However, perhaps look closer to home (and cheaper) than N'market for the testing to be done.......

PM me if you want to know my vet that does the bone scintigraphy.

 

[Ginn]

Oh sweetie, Big Hugs

Really can't offer any advice other than only you know what's best for your horse at the end of the day and you must listen to your own instincts. Sit down with your vet and get him to explain EVERYTHING to YOU, not your YO! He is your horse and if its you that has to make the ultimate decision it is only fair that you are fully in the picture.

I really, really hope that somehow you get to the bottom of this and are able to treat it but I fear, especially with your insurers playing silly b*ggers, that its not going to be quite that easy! Keep fighting and try and keep your chin up.

Big Hugs to both you and Sid - you know where I am if you need to vent.

 

[AmyMay]

Bottom line is that you need to do what you can for your horse. The battle with the insurane company is a separate issue imo.

Oh, and your vet is out of order discussing your horses case with anyone except you!

 

[Bri]

I know we do. But we cannot afford for him to have bone scans/mri etc without knowing the insurance will cover it.

And until we know whether they will pay there is little point in continuing in a different direction and further screwing up my horse!