Funny knee - not sure about what vet says

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zoon

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My horse has had a swollen knee for a few months now. The swelling is across the top of the knee cap and on the tendon sheath above. The swelling is in two separate lumps - the knee cap and the tendon sheath - but vets says it is the same swelling, but there is a band of tissue that goes over the knee that is causing the appearance of 2 separate lumps as it is compressing the swelling in the middle. Swelling feels like fluid under the skin, it is very squishy and you can almost separate it from the knee. And I should add - horse it not lame in the slightest!

Vet came out at first and swelling was quite large - gave 8 days bute and compagel to apply. Horse to be turned out as normal during day, no box rest. Swelling did go down but not completely.

Vet returned to scan knee but was so pleased with how much it had gone down that he didn't bother. Told to start light work in walk and trot for about 15-20mins at a time to see how knee reacts to work. Horse was been worked 3 times now very lightly and knee is very swollen again. Although could have been him having a play in feild and slipping about in the mud.

Waiting for vet to call now. I'm annoyed because I wanted him to scan it and made an appointment to take horse up there on the only day I had transport. Vet cancelled and kindly said he's come out with scanner and maybe "forget" to add call out fee on. Fine I thought. But then he didn't want to scan it after all. Now he might want to come and scan it and I haven't got transport and don't want to have to pay call out fee when I've already had him out to scan and he wouldn't to it - if that makes sense.

Plus I get the feeling he might just say turn him away, as vet knows I'm pregnant, and see what happens - which I don't want to do. It's taken a long time for me to get him looking well and I was planning to keep him going for as long as I can and then maybe put him on training livery until after the birth. I'm 21 weeks now and only just showing.

Horse isn't insured for vets fees due to past issue meaning most of him was excluded and vet knows this, but I have money saved away for such eventualities so it's not like we can't do anything, just have to go into the cost side of things before we go ahead!

I'm annoyed vet has taken a "see what happens" approach when I want him to be more proactive and find out what is wrong with the knee. He is certain the joint isn't involved, but without a scan I don't see how he can tell and I'll be very annoyed if there is a joint problem and expensive horse ends up with arthriris in that knee because of it when with faster treatment it may have been prevented.

Sorry for my rant, but need a bit of advise and support - tomato ketchup crisps and carrot cake for all those that got this far (that's what I'm craving I'm afraid, so thats what you all get!)
 
Is it not just a bursal swelling, like a capped hock. Sounds very much like it and not uncommon.
I'm suprised when it first happened that the vet didn't more proactively try to stop the swelling from getting established. I've known plenty of horses completely unaffected by big fluid swellings on the knee tho.
Has the vet not mentioned this to you? I may of course be way off the mark.
 
He seems completely unphased by it and will happily let you man handle it quite roughly and is not at all worried.

May I ask how vet would have stopped swelling coming up?

It came up over night and he was called after that. Didn't change at all for the first week or so and then started to go down, but it becomes large again after exercise, even light exercise. Even when it is large he isn't lame and doesn't affect the flexion of the joint.

What else can my vet do that I can ask about when he rings?

As far as I'm aware a bursal swelling would just be fluid over the knee, but the swelling extends up to the tendon sheath above the knee so don't think it's that, but correct me if I'm wrong.
 
I really don't know what treatment is these days for a bursal swelling. Years ago we would drain the knee & keep pressure bandages on to stop it refilling. Probs a big no no now. Sounds like the swelling did go down tho & you'd expect a knock to cause it, tho I suppose he could have done that in his stable.
As you say usually expect to see a bursal swelling above the knee. By tendon do mean the extensor?
 
Well that's an entirely different proposition. I think the extensor rarely causes problems and so hasn't the same scary overtones as a flexor, but it's still a tendon injury and should IMO be treated exactly the same as any other tendon injury. I would get a proper treatment & exercise routine from the vet and personally assume he's off games for a few months. Mine with an extensor strain has had 3 month complete rest followed by 3 months walking & then trotting.

If your vet won't take it seriously then I'd get another!!!

He will really want a fully functioning extensor if he is going to be comfortable doing medium & extended work, so you really don't want him to have too much scarring & lesions.

I would get a further scan to see where the tendon is at, & then future scans will make more sense.
 
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