follow up on my horse that physio missed- xrays today!

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jalisco

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you can see my old post aout my horse in my history.
well went to vet hospital to day and horse worked up did flexions on both back legs- both passed. walked and trotted up and back palpated - back def in pain so xrayed.
45 minutes later!!!! - vet came back and said that not Kising spines - so relieved!!!
However- def something wrong in rump area so he recommendending a bone scan/scintigraphy in the next couple of weeks to find root of problem- thinks it may be sacro iliac SI.
Didnt do an ultrasound as he didnt think it was a supra-spinous ligament strain or damage as he wasnt sore under the saddle area??
Only the rump area.
So he wants to do this expensive treatment- 1500-2000££!!!
dont know what to think really. My trainers said that its highly unlikely that he would pass flexions tests and suffer from SI.
Trainer cant understand why bone scan before ultrasound ??? Money??!!

Can anone shed any light on this?
thanks
 
I imagine maybe they feel the scintigraphy is the best way to show any damage in that area? If they went down the ultra sound route and didn't see anything then I imagine they'd have to try the scintigraphy anyway.

However, i am no expert - just seem a lot of insurance claims for horses and scintigraphies seem to be common place. Are you insured or not? if it is your money then i would certainly question it a bit more and ask if they did do the scintigraphy what is it likely to find and what is the likely treatment going to be?

I don't know the history of your case so don't know how long it's been ongoing but if the for example, treatment is essentially only going to be resting the horse anyway then you're going to be better off trying the 'treatment'. If there are bony changes then I don't imagine there is a lot that could be done for treatment anyway in that area is there?

Have another word with your vet if you're concerned - maybe ask for the uktrasound first to rule out a strain anyway (may as well go donw this route if insurance is paying to be honest).
 
Oh its so frustrating when there sore. The bone scan shows up bone and I think ligament issues but not muscles but may well be wrong.

I know your pain but they can pass flexion tests and have pain in the SI region as I know this from experience, My horse is going through this at the moment and I'm currently waiting to see if my insurance company will put the scan through on insurance or not.
 
I wouuld be going with vets over trainers...
If you can afford it/have insurance, go for the tests. But decide what happens then if you do find something. will you be able to afford to treat it? Will it change your plan of action?
 
Hi,

I'm just really clutching at straws really with the flexion test then?
I just hoping for some light at the end of the tunnel.
I want him as a competition horse to jump to at least 130- if higher then that's fab too, however I don't want a happy hacker either. He's not suitable a just a light hack- he's too difficult.
If it's SI what are the chances of him competing to this level again?
I am insured but not for LOU.

Just so stressed out with no horse and still dont know what's wrong or how long if ever it going to take him to heal.
Costing me huge money in livery too so dont want to spend allthat money and nothing but huge vets bills and me horseless.
 
jalisco said:
Hi,

I'm just really clutching at straws really with the flexion test then?
I just hoping for some light at the end of the tunnel.
I want him as a competition horse to jump to at least 130- if higher then that's fab too, however I don't want a happy hacker either. He's not suitable a just a light hack- he's too difficult.
If it's SI what are the chances of him competing to this level again?
I am insured but not for LOU.

Just so stressed out with no horse and still dont know what's wrong or how long if ever it going to take him to heal.
Costing me huge money in livery too so dont want to spend allthat money and nothing but huge vets bills and me horseless.
Click to expand...

As you are insured then i would have whatever scan etc the vets advise to find the origin and subsequent treatment ASAP
 
Shame they didn't look at the feet before really starting to cost you money.

Why didn't they do a lameness workup??

Which hospital did he go to?
 
amymay said:
Shame they didn't look at the feet before really starting to cost you money.

Why didn't they do a lameness workup??

Which hospital did he go to?
Click to expand...

Reading between the lines I assume they didn't do a traditional lameness work up because the horse wasn't actually lame ....

Now, for the purpose of this thread I will assume it was a really good lameness specialist that has looked at the horse (because it is very easy to gloss over 1/10th bilateral lameness')

Having recently been through a series of veterinary examinations for a horse showing very mild physical and ridden symptoms and a general 'not quite right feeling' I have probably been through a similar series of steps OP has.

Regarding SI ultrasound that wasn't done - this area is very difficult to image, x-ray barely penetrates and is essentially rarely worth doing. US again isn't the best diagnostic, completely unfeasibile to US externally, you can do an internal US by going in rectally and looking upwards although the extent of structures you can view is somewhat limited.

This is why you will have been recommended scintigraphy, not only will it highlight if the SI is an area of concern but it can flag up other potential areas of investigation. It is worth noting that a common cause of SI pain is hock injury - I'd be inclined to take quick x-rays of hock and US high suspensories before performing scintigraphy, even though he hasn't flexed lame.
 
As others have said: Ultra-Sound and X-Ray will be inconclusive for SI area due to the SI joint being too deep beneath the soft tissue. Bone Scan is the only thing which will indentify the problem areas within the region.
If you are going through the insurance company I would strongly advise you request an Ultra-Sound of your horses Supraspinous ligament just for peace of mind.

My mare damaged her SI joint in 2007; she had a bone scan which identified this and as a result of other scanning and X-Rays an abnormality was shown on one of her dorsal spines. She had a steroids injection in her SI joint (didn't make a lot of difference) and was operated on to remove the troublesome dorsal spine - she did NOT have KS, just a spur of bone. She had most of 2007 off, all 2008 and 2009 off and had a foal within this time. In February 2010 she was given the all clear and passed as fully fit, she also passed flexion tests etc, but 5 months later it all went horribly wrong and she was diagnosed with the return of the ongoing SI problem, she had multiple holes in her Supraspinous ligament and the tops of the dorsal spines had compensated for this by growing fingers of bone to re-attach to the ligament. She also had possible OCD in her stifles - which could have accounted for the SI trouble in the first place. After all the treatment and time off she had it all came back to bite her in the end and at the end of August she was PTS.

She put up with so so much in the 5 months and she won dressage with 70+% and XC schooled, but all the time I can only imagine that she was compensating in other areas when her SI joint became weaker and this was her un-doing.

Admittedly she probably had a bit/lot more wrong with her than your horse come the end, but unfortunately she fundamentally never recovered from the SI problem enough to sustain a constant work regime of dressage and only a bit of jumping.

There are a lot that do make a full recovery, but there are also those that don't and mine was one of them :(

I hope your horse does and you have a happy ending to tell at the end of it all!
 
Some years ago- Shadow my old horse went through a period of not being quite right. After 3 'normal' vets he went to a lameness specialist which diagnosed a very very slight rear leg lameness. - scintigraphy scans showed up more than we expected- not only a slight hock fracture but also damage to the plates on the knees- we were not expecting this- as there was no foreleg lameness- but he was given 8 months of field rest and returned to work after a second scan showing the plate damages had recovered. It was the best £1600 I ever spent. (well the insurance company paid it actually- but well worth it- ended up being preventative as well as diagnostic)
 
thanks everyone for all your replies, they have been very helpful.
Spoke to my physio who refered me in the first place and she said def go for the scintigraphy/bone scan as it will show any other possible problems - like lameness etc. However he never ever been lame.
She said that if nothing shows up to get more physio and to work on him that way.

anyone else with a horse whos had or having these problems, or SI problems?
and if their horse returned to a high level of competition?
thanks
 
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