Experiences of Scintigraphy please

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Carkst

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Horse, an 11 year old ISH, has been lame coming up 16 weeks. Not hopping lame and at times very mild. Mainly seems right hind but on occasion left hind affected instead. Had physio, saddle fitter and vet. 2 lameness work ups and nerve blocks. Initially vet suspected hocks X-rays normal. Obvious kissing spine on X-ray but vet not 100% certain this is cause of lameness as would expect far worse symptoms. Had steroids into back with minimal improvement. Vet expected more if it was kissing spine causing the lameness. Given 2 options: have classical kissing spine surgery (not suitable for ligament snip) or send to Edinburgh for scintigraphy. Just wondering if anyone has had this done and was it successful in diagnosing exact issue and was it covered by insurance? Any experience regarding findings/outcome would be appreciated
 
One of mine was diagnosed with kissing spine via xray but after no improvement on cartrophen injections and rehab we went for a bone scan and he had no uptake in the spine meaning no KS

He did have multiple other areas, some areas showed up on xrays and others didn't - bone scan was far more sensitive than any xray.

It sounds like you have had a few investigations already and the vet thinks the lameness is not to do with the KS so I wouldn't put a horse through surgery and recovery without having as full a picture as possible. I personally would go for the scintigraphy in your shoes
 
In your shoes I would send the horse for scintigraphy .
It will give you a good over view of the horses bone health .
 
I think I might be tempted to get his back blocked with painkillers and then ride him to see if there is a difference, steroids don't always work.
 
Thanks for all your replies. In response to Porkchop, he has had his back blocked too. There was a marginal difference when ridden but not as much as vet would have expected. It's difficult because it's not always an obvious lameness. Just don't want to put him through unnecessary surgery but then worry it will be something he needs eventually anyway.
 
Did you get ultrasound done to check the suspensories? What led the vet to think hocks might be a problem? If you got some response to nerve blocks in that area, blocking the hocks would also cover pain from the upper suspensories, at least to some degree (aka proximal suspensory desmitis, PSD). PSD is often bilateral and/or mild/intermittent and also often goes together with some form of back problems. It's not always clear whether back problems lead to leg problems or vice versa. But this could be diagnosed/ruled out pretty conclusively with blocks and ultrasound (not hugely expensive). Wouldn't show up on x-rays, or scintigraphy, of course, unless the bone where the ligament inserts is affected as well.

Given the presentation you describe, I'd have a chat with the vet to ask about suspensory problems. Maybe you've already ruled that out, but ultrasound would definitely be cheaper than either surgery or the scans, and less invasive. I don't think I'd be happy proceeding with surgery when blocking and injections don't really give much hope that this will resolve your problem.
 
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Carkst said:
Thanks for all your replies. In response to Porkchop, he has had his back blocked too. There was a marginal difference when ridden but not as much as vet would have expected. It's difficult because it's not always an obvious lameness. Just don't want to put him through unnecessary surgery but then worry it will be something he needs eventually anyway.
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Ahh, fair enough. Then the fact that there was not a huge difference I would go for the bone scan if you can afford it, as it sounds like there may be a few issues going on, sorry.
 
Was very useful with my mare earlier this year,1 practice had already dismissed her spinous processes that were close as not 'causing a problem' & dismissed her antics as behavioural. Subsequent 2nd opinion & referral for bone scan highlighted supraspinous ligament damage from the 2 processes that are close,plus uptake in both front feet & 1 or poss both hinds. She had an entire body bone scan which my insurance paid for. While it did highlight the problem areas we're still no clearer as to why she has so many issues or any closer to getting any improvements! But I'd definitely use this diagnostic again if needed.
 
Struggled for 2 years with one horse.... As 4 year old I was convinced something was not right, felt odd when warming up, everyone including vet convinced me there was nothing, then got bucked off ( see thread in comp Re plate and screws).... Got diagnosed later with PSD in front, then later got told needed more muscle over back, wasn't allowed a day off, needed to ride every day, had 6 weeks good, then odd behind again....Again got told I was imagining it.... After thousands of euros treating various things, physio etc went to clinic, worked up, blocked PSD behind, improvement but not 100%.. Thank God this vet believed me and the massive history essay I had brought with me....suggested scintigraphy.... Immediately diagnosed an old fracture in the pelvis (seat bone) .... Ended up having to put hin down....So yes. Scintigraphy can end up being extremely useful and I wish I had pushed harder when other people were telling me I was imagining stuff. Would nit have changed the diagnosis, but would have saved alot of time, money and pain.
 
Think it was right choice to have scan despite results not being good. Problems in 3 areas. Looking at 3 months box rest and controlled exercise, 2 separate major surgeries and subsequent rehabilitation with an outcome of a light hacking horse only. Totally gutted and don't feel can put horse through all this with no major benefit to him. Vet coming out next week to do one further set of nerve blocks before a definite decision is made. Thanks again for all your replies. Know now if he had just had kissing spine surgery it would not have helped.
 
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