Is it really possible for an Equine Clinic to get it wrong?

LankyDoodle

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Or at least to exaggerate things?

My normal vet came to Lanky two weeks ago on Thursday and was convinced it was puss in the foot, but like my farrier, could find nothing. The fetlock looked slightly swollen and had slight heat and a pulse in it. The vet prescribed IM Penicillin for 4 days, when he would return to have another look. The Pencillin did nothing, and while the box rest meant Lanky had improved slightly in terms of lameness, the fetlock was still swollen etc. So we were referred to an Equine Clinic where they could do all the tests on site, as well as any necessary invasive treatments.

We took Lanky up there last Monday night, and on Tuesday afternoon I received a call from the vet that had been working on him, to say that he'd done nerve blocks and the only one that showed any improvement in his level of soundness was the one into his stifle and that there was some slight puffiness here (ignoring the fact Lanky had a swollen, heated fetlock!). He said he had, therefore, xrayed the stifle and this had shown some changes (which he says are OCD), and that he didn't have time to do an ultrasound that day but would do one in the morning. He said he felt there could be a meniscal tare (the cartilage between the bones in the stifle is called the meniscus) and that this, with the OCD, could be causing the lameness. He said to me that it would be difficult to see much on the ultrasound, but that he should be able to see enough to indicate whether or not that is the problem (the issue with this joint being that so much is hidden away). I said that was fine, because what if it wasn't the meniscus? It could have been a random ligament or tendon causing the lameness, and the OCD a red herring? Afterall, he'd landed awkwardly on his fetlock several weeks beforehand, and had also lost the shoe on that foot... he could have tweaked something (and it was only after this awkward fall on the fetlock and some shoeing problems, that I noticed any difference in his soundness).

The following day I waited and waited and waited for a call. I got through to them and they said the vet was busy. I then got a call at about 3pm saying that he'd been waiting to hear from an ortho surgeon at Liphook to give his opinion on the xrays. He said he had taken the liberty to also xray the other stifle and that there were some very minor changes there as well, but only very slight. I say liberty, but of course I've had to pay for that xray to be done, and will now pay in the way of insurance because they will also exclude that leg. This surgeon had got back to the vet at WC clinic and said he agreed about the OCD and an arthroscopy would be needed to assess the level of damage. I assumed they'd done the ultrasound, but I wanted to know what they had found on it, so I said 'right, so you did the ultrasound this morning and what did that show?' He stuttered a bit and then said 'oh I didn't think it would show anything so I didn't do it' which made me a bit upset because my own vet could have done the nerve blocks and xrays at home, and the ultrasound could have thrown something else, less serious up! Also, if he had no intention of doing the ultrasound, I could have collected Lanky on the Tuesday, rather than paying £50 for a second day's livery at their clinic when he wasn't needed up there!

I went up to collect him that night and they'd injected the joint, put him on daily danillon and box rest, which he is still on now, awaiting his arthroscopy (by the Liphook surgeon) on 14th September. I'm starting to get a bit peed off with them because both me and my farrier saw how Lanky was placing weight on the leg and questioned whether it really could be something so serious (Lanky wasn't weight-bearing even when he was on bute, but now he is). I contacted the clinic and asked for a quote for the surgery (important as my insurer won't cover it all I don't think) and for the xrays to either be emailed to me or my vet so that I can discuss with normal vet so that I have a better idea of what is going on (I feel a bit in the dark at the moment as they don't seem to have a great bedside manner). They emailed them to Liphook, I paid for the xrays to be done, it's my horse, and I don't see why I should not be able to see them and talk to my vet about them. They are totally ignoring my contact! I have emailed three times now, and phoned as well but there was no one that could help me with my query!

I went to Lanky this morning and his fetlock is now even more swollen and hot, and I am beginning to think this whole thing has either been exaggerated so that they can perform costly (to me), profitable (to them), invasive (to my horse) surgery on my boy, OR that they have got it all wrong and he wasn't sound on that nerve block at all. I am just in such a daze with it all and don't know what to do. Now that they have dxd bilateral OCD, I may as well make use of the insurance claim to have the arthroscopy, but while he may have OCD, what if it's not tht causing the problem? Why would stifle OCD cause so much bother with his fetlock?!
 
Oh my word, that is long!
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LOL. Thanks! I don't know where you are, so can't comment, but this is a well-known clinic round here and many people do rate them, but I HAVE known them to suggest pricey treatments which weren't necessary, for other horses I've known.
 
I would be extremely unhappy.

Write to them and ask for a detailed report of what they did and what they found, suggested prognosis based on what they know now and a plan for where to go next. Ask for a copy to be forwarded to your vet and a copy sent to you.
Also ask for them to email your vet the xrays (give vets email addy and a FAO name)

I would not want my horse under-going an arthroscopy until all other areas of potential lameness have been ruled out.
 
It seems very bizarre that they've done all that work on his stifles when it's his fetlock that's swollen! And they only found minor changes there anyway, which could be nothing, just normal wear and tear.

I think yes, equine clinics can get things wrong as they are still run by humans! Have you discussed it with your normal vet? Maybe he/she could get more joy out of them.
 
Thanks Bossanova. I don't really know how to go about this, though, as they supposedly did a lameness workup, nerve blocks and then xrayed the joint that improved with the nerve block in (the stifle) and found the OCD; but as I have found, OCD can occur in many horses and never cause a problem, and until now (having lost a shoe and had the little accident he had in the field with his fetlock) he has always been so sound. I am extremely peed off about them not having done an ultrasound, as this could have shown up some kind of soft tissue damage that does not require invasive treatment.
 
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It seems very bizarre that they've done all that work on his stifles when it's his fetlock that's swollen! And they only found minor changes there anyway, which could be nothing, just normal wear and tear.

I think yes, equine clinics can get things wrong as they are still run by humans! Have you discussed it with your normal vet? Maybe he/she could get more joy out of them.

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Wellt hey nerve blocked the fetlock and he said that it made no difference to his level of soundness! However, the fetlock was very hot this morning!
 
Oh yes, equine clinics can and do get it wrong. I am now wary of using one near me after two less than satisfactory experiences.
 
I sent my horse in to the vets after a suspected re-occurence of a ligament injury.
They forgot to trot him up before doing the nerve block so the nerve block was totally useless. They decided to x-ray and scan without asking me first then phoned in the evening and said they wanted to operate on the ligament in the morning. When I heard they hadnt proven a positive nerve block and the results of the x-rays and scans were inconclusive there was no way he was going under a GA!
So I asked them to detail all their findings in a letter which they did and it all became much cleaere as to the next logical step. 3 months later, nice happy and sound horse.
 
Have they investigated the swollen fetlock or made any suggestions as to why its swollen?

Even if he has stifle issues, he might have been coping with them for years. I wouldn't go ahead with surgery until you've treated any temporary injuries.
 
Right so I write to them and ask for a detailed report of what they found and how, and for copies of the xrays to be sent to my vet? Then I will make an appt with my vet to discuss these xrays. I don't doubt he may have OCD, but I am a bit sceptical because a) no ultrasound, which he said he was going to do; b) swollen, hot fetlock!
 
Well our local vets always email your choice of farrier and you the x-rays so a big equine clinic like liphook should definetly be doing that! I'd say our vets have overall been correct about Henry, but with some VERY good remedial farriery he has got back to doing more than the vets ever predicted.
 
Thanks Flame, this was also my feeling: that he had some kind of injury sustained out in the field (especially as I'd seen him land awkwardly on his fetlock - sounds like what Puppy's Believe did, but he was trotting when he did it and had no rider on) and the OCD was a red herring. He's 8 years old and has never, until now, had a day's lameness. He was backed and schooled by friends and was always so sound for them.

Amy louise - they are WCEC and are based in Culmstock. They are widely known round here. A lot of people really rate them, but I don't understand this at all.
 
My friends horse went for x-ray and they showed up all sorts of things with the alignment of his joints but the vet still thinks it a crack in his hoof that is making him lame (full thickness and near the back of a front foot).

I think vets can be distracted by x-rays and once they get an idea in their heads they can ignore more obvious things.

I would ask your vet to call and get the x-rays so that you can discuss them.

It is so wrong to be paying what we do and not have time spent with us to explain what is going on.

Keep pushing and don’t let them treat you like a neurotic mother.
 
This is a bit of a soapbox of mine.
I know what you mean some times it feels like 'we have the technology!!!' Once you have got the horse to the hospital then you almost have to have everything they suggest done rather than have to take them back at a later date.
If areas have never been xrayed bfore then how do we know whether any changes are new?
I am in the position where of my 4 horses 2 are on full insurance and 2 due to age are now veteran so I do take quite a lot of care in discussing with the vet just what they do and why as I have to pay the whole bill on the veterans if it isn't 'injury'.
Sometimes with 'feet' I do feel the farrier is the best for first port of call and sometimes rest and waiting should be an option not always dynamic intervention.
I think I blame insurance for this as everything is time limited and they exclude stuff very readily so people need to take action almost too quickly.
if we all had to fund things out of our own pocket then things would be different I think.
You certainly have my sympathy on this.
 
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Well our local vets always email your choice of farrier and you the x-rays so a big equine clinic like liphook should definetly be doing that! I'd say our vets have overall been correct about Henry, but with some VERY good remedial farriery he has got back to doing more than the vets ever predicted.

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Sorry I should have made myself clearer. The clinic I used isn't Liphook, but the vet used to work at Liphook so emailed them to an ortho surgeon up there (who is going to do the surgery). The clinic is here in Devon and is well-known.
 
Goodness me
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I'm sorry you're having such a hard time
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I think yes, sadly vets can and do make mistakes. There's two practices in my area that I won't use as I just don't trust them
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I was very very very unimpressed with their explanation. When I went to collect Lanky, I asked to speak with this vet and he came out to my trailer and just stood there waiting for me to speak. I was a bit dumfounded actually. I am used to articulate vets who offer explanations in laymans terms (although I can understand a lot of the complex stuff if they are incapable of that!).

They said they could find nothing in the foot (this was their initial concern as he has bad feet in summer, lost a shoe - abcess, nail bind etc). Then they did the work-up and nerve blocks and pinned it down to the stifle. Well what about his effin jeffin fetlock then you moron!?
 
libh, you are right. I was going to leave him on bute and box rest, in which case I probably wouldn't have called the insurer at all until intervention was needed. It turned out that he had these investigations so I had to call my insurer, and now I have this 'diagnosis' over me, I am thinking I have to decide whether to have the arthroscopy or not. With this diagnosis, they are going to exclude those back legs now anyway (although I haven't given them the dx yet), so what if he needs the arthroscopy in future years? This is what makes me think this is my only chance to get it sorted.
 
OK, I've written the letter requesting a full, detailed report of what was done and what was found, and I am waiting to hear back from my normal vet about this fetlock. I'm going to hand deliver the letter tonight and we will see how soon they get back to me; but I have requested it to be done asap, as the surgery is scheduled in 2 weeks.
 
Exactly, papafrita. I am guessing it's because his fetlock won't make them as much of the old £££££££££££££££s I can't cope with all of this. You just expect your vet to do their best for you, don't you?! I am guessing this clinic saw me as a referral with insurance (that is the first question they ask when they admit your horse!) and there we have it!

So I am waiting to hear from my normal vet who I am going to ask to xray the fetlock. Lanky is on Danilon and box rest, so in that sense, we can't do a lot more, but he's not really getting any sounder (he did improve, but hasn't improved since then if that makes sense).
 
I do feel for you LankyDoodle as this is exactly how my story went with Flin when he went to the Clinic (not same clinic as yours).

I had all the meniscus tears and OCD scare stories as to what it could be and they need to arthroscope asap etc to see whats going on. The xrays showed what could have been a bone spur and some rough cartiledge which they showed me and explained to me.

I agreed to the op to find it was just soft tissue inflammation and what looked like spur and rough on xray was actually normal when they got in there! £5794 later and joint injections and anti inflammatories would have sorted it alone!

I have many more issues with the clinic about treatment and their aftercare as I feel I was just an insurance pot of money for them in the long run.

Could your own vet xray or check the fetlock in the meantime? If the problems turn out to be stifles and fetlock the insurance company should pay out for both but as a separate claim.

I do feel for you as I know exactly what your going through. I hope you get some answers from the clinic so you can decide which action to take.
 
You know, I continue to be gobsmacked; it sounds as if they're saying "Oh, we don't know what's wrong with the fetlock, so we'll look until we find something we can treat". Why on earth did they not x-ray the fetlock BEFORE the stifles??? Strikes me as VERY unprofessional!
 
If it were me I would be going over the fetlock with a fine tooth comb, looking for a puncture injury - I've seen tiny thorns and bee stings cause disproportionate amounts of swelling and lameness. I would also be cold hosing several times a day to try and reduce the swelling. I would definitely get your vet to x-ray the fetlock, and would want x-rays and reports reviewed by another vet before surgery.
 
It does seem strange that they haven't done anything to the fetlock. Did they say they had ruled the fetlock out as a cause through the nerve blocking, because they should have worked up from the foot to the stifle with the blocks. It sounds like a good idea getting your vet to xray the fetlock, if nothing else for your own piece of mind. I saw a horse a horse a couple of weeks ago while on placement that could barely weight bear on a hind leg, and from the way she was holding the leg the vet thought it was the pelvis. Money wasn't really an object with the owners, so the vet decided to xray the foot but found nothing. While the xray was out, they decided to xray the opposite hock which had a bog spavin, and found OCD in the joint. Out of precaution xrayed the other hock, and found OCD in that too. Despite this, the vet didn't think this had anything to do with why the horse was lame!
 
I am totally untrusting of vets so I would get a second opinion if I were you.

My (old) vet told me that my horse was fine to ride after a weeks box rest for what vet thought was a small cut just below her hock after a kick in the field.

One weeks box rest and one ride later, return back with crippled horse. Different vet came out immediately, did x ray and found fractured splint bone and infection that was at risk of going into the hock. I still cannot ride my horse 18 months later due to complications etc.

Given that whole experience I am really sceptical about vets and always want a second opinion, especially if they say that something majoris wrong. I have now had 4 different vets out to El (the 4th is coming out tonight) to make sure I have an accurate picture of what is going on.
 
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