Horse lame - but is diagnosis correct

Bosworth

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www.ballhillequestrian.co.uk
One of my liveries has an old horse - approx 20. he was brought in from the field about 5 weeks ago, seriously lame in the R hind and dragging his toe. i checked his leg throughly, palpating through the stifle and hock and he was very boggy around the stifle. Owner ( novice - only horse) decided to box rest for a couple of days and turned out again. He was brought back in by another livery within a day as lame again, and toe dragging. he was back on box rest but the owner insisted on turning him out daily in a very small paddock. He was sound on the flat concrete but in the field again becomes very lame and toe dragging. I asked her to get the vet out as clearly there was a serious problem. Her vet is unfortunately limited in the availability of good horses vets, and the one who came out basically said it was arthritis in the hock and he needed to be on box rest for 4 weeks but could be turned out in small paddock. I queried this as diagnosis made without xray or scan and in my experience arthritis is buted up and turned out to ensure constant mobility, whereas ligaments should be on strict box rest. I was there one day when the horse was turned out in the small paddock, it flipped, turned itself inside out and was crippled lame again on hind - but sound on flat concrete. So I put it straight back in and insisted she get the vet again as it was clearly no better for the 3 weeks rest. Another week on and she finally got vet out. I was schooling my horse while he was here so I know he only trotted it up on the flat, I suspect she hasn't told him he goes crippled on rough ground. I know he has not been scanned and the vet's diagnosis - he has arthritis so needs to be turned out daily in small paddock to get him used to going back out.

Now in my experience toe dragging and crippled lame on uneven ground and sound on hard flat does not tie in with arthritis, it is more likely to be ligament, and turning him out to throw himself round is going to cause serious problems.

if it were my horse I would definitely want a scan and xrays to provide a definitive diagnosis, but this livery is really inexperienced and believes everything her vet says. I know this horse is going to go hanging lame as soon as it goes in the paddock, so do i just ignore it, bring it in each time or what? I don't really want to interfere but nor am I prepared to have a horse on my yard that is crippled lame without a firm diagnosis.
 
Crippled lame and toe dragging sounds like stifle to me, especially as it is boggy round the stifle region.
Can she not get another vet out? I would really be asking for a scan.
And yes, box rest. When my lad injured his stifle, it was a sprain and resolved quite quickly to mild lameness with bute and strict box rest but he was still box rested for 3 months, with gradual walking exercise only being introduced 8 weeks into his convalescence.
 
I didnt think they could diagnose arthritis without x-rays/scans?!? Or was he already suffering with it and the vet thinks it has just gotten worse?

What does the YO have to say about it?
 
Bosworth- If it's your yard I'd tell the girl that you are not happy with the diagnosis and would like her to get a second opinion. However, if she won't then I guess you just have to go with it or give her notice. The horse won't die because it's lame although obviously it's not nice. Best of luck, it's a horrible situation to be in!
 
Also, isn't arthritis usually a slow-developing condition, rather than sudden-onset crippling lameness??
 
I am the YO and I have insisted she get the vets out twice now - and this is the result. he has allegedly got arthritis already - however that was a diagnosis made years ago without any scans. I have had 2 issues with this vet in the past with various liveries horses, one where he diagnosed check ligament and back into work - and eventually that horse had to be PTS as diagnosis was completely wrong and another vet did scintigraphy and scans and discoverd shoulder joints absolutely covered in cysts. And another where navicular was diagnosed in a new to yard horse, but when my farrier saw it he was adamant it was bad shoeing, reshod it and over a period of 8 weeks it came sound.

Do I as a yard owner leave her to it, or intervene and insist she gets a decent vet out to scan. i am convinced this is stifle and soft tissue - not arthritis.
 
I would have also thought that it is not arhritis and would be getting a second opinion. As it is your yard you are responsible to make sure the horses are looked after properly( im sure you know this seeing as you posted on here please dont take any offence just stating it for the purpose of the post) and if it were me i would having a serious talk with the lady, voicing my fears and asking her to get annother vet out for a second opinion. Id be thinking ligament damage and be wanting scans and xrays.

Not a nice situation for you at all and i hope you resolve it soon
 
Gingernut - no offence taken at all, I am going to phone her vet - I know him and did see him yesterday but didn;t talk about horse as I assumed she would tell him everything and I didn;t want to interfere.

I think I will ask vet if he was trotted up on rough ground, or just in the concrete yard. And if he says concrete yard then I am going to tell him about him being crippled lame on rough ground
 
Sounds like a ligament problem round his stifles, doesn't it?

Why not ask her if she would like your equine vet to look at the horse? I can understand her not wanting to go the expense of scans and x-rays on an older horse - but agree that a more experienced eye than her vet is needed here.
 
Maybe you also need to have a sit down with your livery and explain that, as YO, it is your responsibility to ensure the horse is being looked after appropriately. Say that the livery is doing the right thing by getting the vet, but that you have doubts regarding the diagnosis and you would like a second opinion / scan, in the best interests of the animal.
If you involve the livery in all stages, you will not alienate her and the two of you will be able to work towards resolving whatever is wrong with this horse together. If she feels you are going behind her back, that could possibly be counter-productive and she may then resist any intervention from you, potentially to the detriment of the horse.
Good luck - not a good situation, but one requiring a lot of tact!
 
Just as a general point, if you have a horse that has a known condition, then vets can tend to assume anything that happens is as a result of this and not look any further.

Sometimes you have to be quite determined to push them further, not easy if you're a novice owner.
 
Well just come off the phone to her vet, it would appear she has not told him anything about the total lameness on uneven ground, he trotted him up on the flat concrete and can clearly see the stiffness all round which I agree is arthritic. However when i have told him about the uneven ground, the boggy stifle, the fact that 7 days ago i insisted it was not to be turned out at all as I was convinced it was ligament or stifle, he has agreed he has only seen a quarter of the picture. I have told him I am not happy to be seen to interfere as she is not open to any suggestions so have asked if he can pop in on his way home and just pretend he is doing a quick check in passing. that way she will think he is being efficient . I have also given him authority to put the horse in the paddock if he is in his stable so he can see for himself the extent of its lameness and I have suggested he needs scans - but have left that for the vet to advice livery on.
 
What an awkward position to be put in Bosworth. For what its worth I too agree that this sounds like soft tissue.
 
When she keeps dragging her toe has she got a stright leg and can't bend it? Locking stifle was what I was thinking but not sure if she's dragging toe when she's walking or can't bend leg at all?
 
Explain to her that your first responsibility has to be to the welfare of the horse and not to keeping her happy, therefore you are insisting on a second opinion because the diagnosis given does not tally with your experience of arthritis and you want further investigation done.

She can leave if she isn't happy about it (but she wont)

When she comes to you with an apology because you were right all along be sure to tell her you want it with a cream cake :D

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Ah well done OP- a very good solution!! Fingers crossed vet will now be able to get to the bottom of it :D
 
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