End of my tether - advice please?

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Annagain

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I know a lot of people have worse problems than me, but I really feel like I'm at the end of my tether with my horse's lameness. It's been 3 months now and I feel like I'm getting nowhere.
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If I'd been told at the beginning that it would take 6 months or however long it would be ok, but I keep getting told it should only be another week or so, but it's going on and on. Sorry this is long, but here goes.

3 months ago I found my boy lame in the field, not hopping but certainly hobbling. Vet came, thought it was just a tweak, prescribed field rest and bute. While on bute sound as anything. Came off bute and not quite right so back to vet. Full work up suggested a foot problem, nerve block confirmed this so x-rayed the foot. It showed bruising to the pedal bone and vet said soft tissue damage usually goes hand in hand with it.

He'd already been off 3 weeks at this point, vet prescribed more bute and gentle exercise, said another 3 he'll be fine. Came off the bute after 10 days and was fine, upped his work slowly and 10 days later was still fine so went on my planned riding weekend (vet said to take him as long as he was sound as it's only hacking) but took it easier than I normally would and no problems.

Home from riding weekend and was fine for 3 days. He wasn't ridden as was having a break after the weekend away. On the 4th day he was lame again - as bad as he was when it first happened. Gave him a bute, next day was a lot better but still not sound so back to vet again. Vet said he'd probably overdone it and aggravated it, keep going with gentle exercise and up it slowly as he improves.

He's been like that ever since and hasn't improved at all. He's sound in the field but lame on hard ground. He has good days and bad, on good days is vitually sound, on bad days is crippled. The norm is somewhere in between. Some days he's lame in trot and ok in walk, other days it's the other way round. I've tried a few strides of canter when he's had good days and he's far better in that than any other pace. He's barely been ridden as I don't see the point in flogging him in terrible weather when nobody's enjoying it and he's not improving, so he can't have done too much.

We're going back to the vet tomorrow. Does anybody have any advice of what to ask him to do next please? He's insured and they have already paid out for treatment so far, so in principle, I have £4,500 and 9 months left to sort this out. Shoud I try box rest (not an option I want as he hates being in at the best of times and would be in by himself.) or a small paddock (YO would allow this, but would have to ask a friend if I could borrow her pony to put in with him as he doesn't cope well by himself). Should I ask for more exploratory work? Maybe an MRI (if my insurance will cover it)? I'm beginning to wonder if this second lot of lameness is actually something different as he was sound for a good 2 weeks between the two. If anybody has any suggestions or ideas I'd be really grateful to hear them as I don't know what to try next.
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Then once he's sound all I have to do is decide whether to sell him or not, but that's a whole different story
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Is your vet absolutely sure he hasn't cracked his pedal bone rather than just bruising it? It can sometimes be difficult to show up on an x ray. I think if he were mine I'd want more investigations to find out what was really going on and if you can't find out any more then turn him away for a while.
 
I would demand a diagnosis - as you haven;t had one. The only way that they can diagnose is by doing scintigraphy to establish exactly where the problem is - or MRI if your insurance will pay for it. One of my liveries had a pony diagnosed with a check ligament problem and given box rest then a programme that would take 280 days to fitness. he had nerve blocks and a full lameness work up and vet decided it was definitely check ligament. I disputed the diagnosis as it was not exhibiting any classic symptoms and insisted on scintigraphy. under scintigraphy we discovered that the problem was actually a serious problem in both shoulders so the pony was actually put to sleep as no treatment would ever solve the problem. The insurance paid out full value. If my livery had gone with the original vet's diagnosis she would have reached her 12 month insurance limit and would have a horse that was still undiagnosed. I am now starting to force my vets to more proactively diagnose - as I have seen the situation you have now continue for far too long.

Force a diagnosis - insist on a referral to a diagnostic practice. but I would also insist on the diagnostic practice being sent all the current work up notes as you don't want to shell out for exactly the same lameness work up to be carried out yet again. I am not sure which insurance company you are with but mine NFU have always paid out for the scintigraphy as far as I and my clients are concerned. If you are pushing for scintigraphy then find out which of your local vet hospitals have it. One of our local vets down her refers to places miles away as they have friends there, when actually we have another local vet that does it about 25 miles away. Prepare to override vets egos - some of them as highly developed and sulks are fairly common with one round here.
 
Are you sure that this 2nd lameness is not a continuation of the 1st? I'm not a vet but in my experience, bruising to bones takes a long time to heal, and while it can settle down quite quickly and give the appearance of having come sound, it can also flare up again if not given enough time to finish healing (like splints)

I suspect that he might need some proper time off - ie box rest or very restricted area - with no exercise - to let the bone settle - otherwise he's going to keep being intermittently sound/lame for months.

I hope that the vet can give you a more definite answer - it's very hard thinking you're getting somewhere and then having setbacks.
 
Sorry to say when my neighbour's vet recommended MRI scan, the insurance company would only pay half the cost (over £1000) and said that this was the norm. That horse was eventually found to have a cyst within the structure of the foot.
I have found that magnet boots can be very useful for pain relief and are supposed to help healing.
 
I can sympathise with you as my mare had been out of action since April. Shes had a small joint mouse removed from her fetlock (bone chip) and also was found to have an inflamed tendon sheath in her hind leg on same side. 4 wks box rest then 2 wks in field. On day 4 in field came in lame on fetlock damage leg, bute and box rest again. Vet thinks shes had a bruised sole as xray revealed nothing going on inside and her hoof was warm compared to the other one. 3 weeks after field incident we have started gentle 15mins walk out (ridden) and is still a little pottery but we are now doing controlled exercise and keeping her out of the field until shes stronger. She didnt like box rest but has adapted so if it comes to it, dont get too worried about it. It is frustrating and worrying and I do hope she hasnt got anything else going on which we may not have discovered. Have painted her soles with Ketatex hoof hardener and keeping fingers crossed.

An MRI may be the best way forward for you, I believe these show up just about anything. Hope so for your sake.

If only they could talk eh! My situation has been helped by being able to ride another horse thought theres nothing quite like riding your own horse. Was so nice to get back on her after 4 months even if every step we took was a tentative one.

Good luck with everything
 
Yes - sorry forgot that bit. Recommended trimming toe short and leaving heels long, and shoeing slightly further back. Vet has seen shoeing and is very happy with it, although did say we could try wedges/raised heels if this didn't work. Farrier coming out Thursday so will check what vet wants doing tomorrow.
 
I would try a farrier remedial one, see what they say. We had a horse that kept doing sound then lame, the farrier fixed it within a month and then slowly changed back to her normal self.
Also we had probs with a part of the field as there were stones under the the surface that we could not see or feel. But as soon as we fenced that part off the horses kept sound.

Good luck and try not to let the lameness choose on selling or not. XxX
 
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Yes - sorry forgot that bit. Recommended trimming toe short and leaving heels long, and shoeing slightly further back. Vet has seen shoeing and is very happy with it, although did say we could try wedges/raised heels if this didn't work. Farrier coming out Thursday so will check what vet wants doing tomorrow.

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Ask your vet about shoeing with heartbars - rather than wedges, and go from there. You could also ask about gel pads as well.

Most of what you've described, my horse has recently gone through. Farrier and vet consulting together have ensured a speedy recovery for my horse.

Good luck.
 
Does he normally have good feet? My horse has been very slightly intermittently lame for more than 6 months and it seems to be related to hard ground although not always. After a lot of scans and x-rays (although we haven't done MRI) the vet said last week that she thinks it is due to him having very crumbly bad feet that often get sore, particularly on the heels. I always knew they weren't strong feet but didn't realise they could cause so much soreness. He is currently without shoes as the vets took them off, and he is incredibly sore on hard ground even just walking around - I'm not riding at the moment. I can now see why even when he is shod, he is not perfectly sound.

The vet has recommended sole pads for hard ground but mainly said that only good management will really help him.
 
No lameness is not the issue with deciding on selling or not, that's a whole new can of worms. Have to get this sorted and then address that issue! That's an even longer story than this one!
Amy May - vet and farrier have spoken on a few occasions, both happy with what the other is doing, although will ask about heartbars. Vet was even there, by chance vaccinating another horse, last time farrier came and watched him trim his feet, so they are both singing from the same hymnsheet.
 
Angela_l_b. Yes he has pretty good feet and we've never had any trouble before in the 4 years I've had him. He's also spent the majority of his time in the field he's in now, other than when it's being rested, so I don't think that's the problem, thanks for the suggestion though!
 
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Amy May - vet and farrier have spoken on a few occasions, both happy with what the other is doing, although will ask about heartbars. Vet was even there, by chance vaccinating another horse, last time farrier came and watched him trim his feet, so they are both singing from the same hymnsheet.


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Perfect. I'll keep everything crossed for you that your horse starts to improve.
 
Hopping Lame usually has a direct and sudden cause, low grade ongoing lameness usually indicates somethings going on.....
My mum had a horse that presented with low grade lameness and I know that we would have wasted 6 to 8 months of time on box rest and treatment had we not gone down the MRI Scan route.
Sadly for my mums horse his Dressage carear was over before it started. The scary thing is, at purchase and diagnosis his Xrays were clear, but the MRI Scan showed soft tissue damage from a previous injury that was only going to get worse - we speculate he was injected before being imported to make him sound before we bought him and the timings of the lameness suggest it was wearing off which is obviously not the situation in your case.
Just from the perspective of getting to the bottom of it quickly i'm for MRI's every time - you also know exactly what you're dealing with and can start appropriate treatment
 
oh you poor thing *tea*

ive just been through something similar ( compression of pedal bone ) and he DID has come right with treatment, but i understand your frustration!

my boy has always had great feet, but xrays showed his toes were too long - depending on where the pedal bone is bruised you could try natural balance shoes.

also it sounds weird, but in order to heal, the circulation needs to be good to the hoof and exercise will help with that - bute will help with the pain.
 
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