lameness in right fore..at a loss

[hock]

I feel as though you’ve been really badly let down by the vets you’re using and I am so sorry, this sounds like a nightmare. They have a duty of care regarding steroids to make sure you’re aware of the risks and lami is a real concern as you’ve experienced. So bloody depressing.

I have an orthopaedic vet that I use for any body/work/ridden/lameness issues unless it’s an enmergency. I really like the vets practise I am with but the ortho vet I use has been fantastic and it’s worth the wait for her to visit (she’s from the Netherlands).

I think the time has come for you to get a second opinion and I’m afraid I would want to go to Newmarket. You’re looking at about £1000 I think for a lameness work up and X-rays etc. But you need some peace of mind.

I always pray it’s an abscess. Going forward you must find a team you can trust and rely on. Not getting call backs and having to nag vets is no good. You sound like a fab horsey mum btw.

 

[chocolategirl]

hi everyone, hope you're all keeping well

I really need some help and advice.

firstly a brief recap / timeline of lameness with my mare..

june 2020 - discovered suspensory ligament in left fore had a massive hole. vet noticed right fore off aswell, which was also nerve blocked but i can't remember if it was treated. the left fore had PRP treatment twice, months of box rest and controlled inhand walking- then a sick paddock, where she exploded. ended up turning her away oct-dec

jan 2021 - revisited vets, ligament healed well, given the go ahead to ride

feb 2021 - had back, saddle and teeth done before riding, started off OK- then we had issues with her standing at the mounting block. I had major confidence issues as a result, tried a few groundwork lessons but we still had trouble getting on.

march 2021 - managed to work on my confidence, but she still wasn't right. had physio out again who commented on how tight she was in the back, rang vet for advice. scheduled an appt for april.

april 2021 (early) - she was diagnosed with bone spavin in both of her hocks, which were treated with steroids initially. also the vet found her to be tight on her glutes/lumbar/sacrolilliac. she had shockwave treatment for this. i held back on ethanol and tildren treatment as i wasn't sure if insurance would pay out. contacted tom beech, who said to contact him again once we had fully established a treatment plan.

april 2021 (end of month) - vet rescanned ligament on left fore and was really pleased with the progress. went ahead with ethanol and tildren treatment.

may 2021 - we were riding!!! oh my goodness, she was the BEST she's ever felt in walk, striding out beautifully and so happy/relaxed.

june 2021 (early) - i was given the go ahead to start trotting. i posted about being unsure of her paces and asking if anyone could help me on the ground. ycbm kindly visited and gave me a completely honest opinion that she didn't think my mare looked sound (ycbm you may need to comment on what you've said, as I can't remember the technicalities!) but she suggested about asking about blood tests.

june 2021 (mid) a week or so later, we went back to the vets for a second lot of tildren, shockwave etc. I asked the vet about blood tests for cushings and she said there was no point. the vet commented again she was off on her right fore and asked did I remember if it'd been treated. now theres been so much going on I wasn't sure. so I said I wasn't sure but possibly. she suggested steroids in the right fore.

june 2021 (end) - my mare quickly went lame, within a week or so - felt flat and not herself. lo and behold she had lami and racing pulses in her fronts. rang the vet 3 times and begged for them to come out as she wasn't right,vet admitted it was good i'd pushed for this! my mare had blood tests at this point, no cushings/EMS came back. the lami was a result of the steroids in right fore, i wasn't advised lami was a risk of steroids

july 2021 - mare developed cellulitis on box rest which I had to fight for a vet to come out for. bought ice boots. she then began to get super bitey/unhappy around hind gut area. whisked her off to vet clinic where she got diagnosed with ulcers. these are being treated

mid july 2021 - had physio to keep her comfortable, vet came out to do injection for ulcer treatment and i asked her to do a general check, so trotted up and dog lame in right fore. vet took a video and referred to my orthopaedic vet. my orthopaedic vet agreed with me turnout was needed as she was getting worse and worse on box rest mentally and also in her legs. mare allowed turnout to be increased. also had a worry about her eye but that was just from a fly THANKFULLY!

present - still dog lame right fore. vet came out on tuesday, was shocked and said she'd call my orthopaedic vet. she said there were pulses in right fore but not laminitis. no answer from orthopaedic vet. she said to keep up with the turnout and basically said to just look at the leg when shes in for her rescope in a few weeks. shes not getting better so i chased yesterday, no answer.

Basically i'm getting really worried and i don't know what to do or what to think. have I done something wrong?

apologies for any spelling mistakes i'm quite stressed!

xx

Is it possible it could be a deep rooted abscess? I’ve heard of this before, where an abscess formed causing the horse to be dog lame, pulsing like mad, but because it was so deep in the foot, it couldn’t get out if that makes sense? Have you had any nerve blocks done? Hope you get some answers, what a nightmare for you ?

 

[Pinkvboots]

I would change vet and get the hooves x rayed and go from there.

 

[SO1]

Gosh your vets sound awful. They should document all treatments your horse has had and a quick call to the practice would have enabled the vet to confirm if the right fore had been treated.

They should have told you about the laminitis risk. Interesting the laminitis and steroids risk is part of the standard form they vets use for discharge notes at my vet. My pony had a scan and then I got the discharge notes for his rehab for his tendon injury and it said on there about the steroid risk and laminitis even though he had not had a steroid injection.

I would not be surprised if it was laminitis the sugar levels in grass have been high. I am also surprised they let her off box rest so soon after laminitis.

 

[hollyandivy123]

https://horseandrider.com/horse-health-care/finding-horse-digital-pulse

Hi OP

Here is how to take a pulse, once y I u know where it is on your it's easy to find, I suggest you take daily pulses and compare with another couple at the yard and try and take a record each day.

 

[Trouper]

Gosh - what a typical tale of vets treating only the individual problem they see in front of their eyes. I, too, would be changing vets. However.......

By the time you get more than one issue that is not resolved I always think it is time to call Tom Beech (The Osteopathic Vet) who will look at the whole horse. The fees he charges are worth any number of visits from other vets and you have a comprehensive assessment. I know he can be difficult to contact for an individual appt. but there are clinics at various places that you might be able to attend?

 

[Jellymoon]

Gosh I fell so sorry for you, and also the mare who must be getting quite stressed with all the vet visits. Why are they scoping her? Does she have ulcers too? Did I miss that but? That could be from having to stay over at vets every time. Seems very odd to me.

Your vet does sound like they are not giving you good service at all, I cannot imagine my vets treating anyone like that. Even the receptionists seem to bend over backwards to be helpful, and that’s how it should be. They should have the equipment to come to you, no question.
A few have mentioned Tom Beech, who I know has really helped many people and has a big fan base. My experience with him was not like that though. Thoroughly nice chap, but did a quick bit of body work for £250 (or thereabouts) and sold me a very expensive supplement, which did nothing, then said he would come out in a few months and do another treatment for another £250. Made no diff to my horse at all. Maybe he will sort your mare out and it will be money well spent, but just don’t get your hopes up like I did, might not be the miracle cure.

 

[Tiddlypom]

Maybe later on for an osteo or chiro vet visit, but this horse's acute present problem on the RF needs addressing first.

IIRC the OP was earlier thinking of getting, or maybe has now had, a osteo/chiro vet visit for her mare?

 

[ycbm]

I understand the call for holistic treatment when it's difficult to work out what's going on or where to go next. But there's honestly nothing subtle about any of the stuff that's wrong with TA's horse. It can clearly be seen where the issues are and they have already been identified with good diagnostics, except for this severe front foot lameness following a lami episode.

It's a real shame that she doesn't seem to be responding well to the joint treatments so far, but I'm not sure this is the time to be consulting a third person with a new vet practice about to take over care of the horse.
.

 

[Tracking_up]

My 'not quite right' horse, that got lamer through the various vet visits (at one point 'dog lame' with slight pulse), needed an MRI to diagnose a chronic DDTF tear in the hoof, which had (partially) healed with adhesions to the navicular collateral ligament....

This was after a vet had initially diagnosed a touch of arthritis in the coffin joint and medicated for that. But we had to continue the investigation as that medication hadn't solved the lameness. Sometimes, there are several things going on....

 

[throwawayaccount]

thank you everyone for your detailed replies and pointing me to various resources, i really do appreciate it, i'm forever grateful to this forum and its members for the support i've received (and continue to)

i did contact tom beech a few months ago and he said to contact him when a treatment plan had been established. we then had something tentatively booked but i had to cancel for one of the reasons. my girl has been having physio once a month, i appreciate thats a different ballgame to chiro but its more to keep her comfortable each month and just to keep on top of things superficially for now. i really wanted a chiro work up once she was given the go ahead for ridden work (if any) just in case.

she was diagnosed with ulcers a few weeks ago, as i noted she kept trying to bite/kick me when grooming her- which wasn't like her so i panicked.

ycbm- i know, i sometimes think its made a difference, but since the steroids shes gone about 10 steps back.

tracking_up you have hit the nail on the head about several issues going on. or one leading to another i'm going to google about the DDTF shortly.

my vets keep mithering me asking why i'm changing practices and getting someone else to look at my mare. they rang me yesterday asking why and also to release medical records which i ok'd. i said i didn't want to find my horse dead in the stable and that she needs seeing soon as shes getting worse and its not been taken seriously. but I've had a text from my orthopaedic vet asking why i'm getting someone else out.

i'm thinking of just writing an email to them and putting everything in it.

xx

 

[ester]

You don't have to justify yourself beyond 'I've not been happy with the service received thus far'. TBH you don't have to justify yourself at all. Quite communicative when you're going elsewhere though compared to previous.

 

[Tracking_up]

i'm going to google about the DDTF shortly.

Apologies with my spelling - it's Deep Digital Flexor Tendon (ie DDFT) !! in case you are googling it

 

[throwawayaccount]

thank you both!

and thats true ester, I think I was over the top with the stable comment, just utterly frustrated I think. i'm usually very calm and don't react to much. which is probably part of the problem as i've just accepted things and not questioned it as much as I could have x

 

[Midlifecrisis]

I realise as I type this is a very simplistic query but does your horse kick the door? I have been at a yard where intermittent lameness on a foreleg had explorations and finally vets said bruising of tissues in hoof from the concussion. The stable was rubber matted on the door and a tyre fixed and I believe the situation came good. Hope you get a resolution soon.

 

[SEL]

my vets keep mithering me asking why i'm changing practices and getting someone else to look at my mare. they rang me yesterday asking why and also to release medical records which i ok'd. i said i didn't want to find my horse dead in the stable and that she needs seeing soon as shes getting worse and its not been taken seriously. but I've had a text from my orthopaedic vet asking why i'm getting someone else out.

i'm thinking of just writing an email to them and putting everything in it.

xx

I feel for you! The vets I was using did everyone at the yard so changing from them was awkward to say the least. I didn't get into debate. I just said 'thank you for your time, please release the records because I have organised a second opinion'. I then left it there.

 

[Lady Jane]

Where do you live? How have you chosen the new vet?

 

[brighteyes]

I have to say that in the circumstances where the need for a Cushings test, based on an observation of sore soles, was queried, I would have refused to pay the bill for treating the laminitis which directly followed giving steroids to a horse with known sole sensitivity.

But the horse is insured, so that's "just" another upsetting incident for TA, and a higher price for everyone's insurance next year.

Well done for calling another vet TA, I hope things get better from here on, she's a very nice mare.
.

With roller skates on - they'd be getting a strongly-worded letter from me as a precursor to declining the bill and demanding free on-costs!

 

[brighteyes]

You don't have to justify yourself beyond 'I've not been happy with the service received thus far'. TBH you don't have to justify yourself at all. Quite communicative when you're going elsewhere though compared to previous.

Time for some straight-talking...

 

[Pearlsasinger]

OP, as well as everyhting else, I would seriously question the 'no PPID' test result. Please ask your new vet to do a TRH-Stim test to ascertain whether she really is a PPID horse or not. We had a mare whose ACTH tests came back ok several times but we were suspicious of her symptoms and she had a TRH test which came back 8 times the normal limit.
Fwiw, I think you are doing exactly the right thing changing vets, the first lot sound dreadful. I hope you manage to get your mare sorted out.

 

[throwawayaccount]

apologies for the delay in replying x

midlifecrisis- she kicks the door occasionally, that's a good point- thank you

SEL - thank you, I think its kind of the same for my yard - half use my first vets and half use the ones i'm changing to!

Lady Jane- i'm based in cheshire, yes have chosen new vet

brighteyes - I know what you mean, but i didn't want any hassle and just paid what I owed- they are trying

Pearlasinger - that's a good shout, i'll make a note of that in my phone so I don't forget.

--

the vet is coming around 4pm this afternoon so fingers crossed, i've kept her fully box rested the past few days (no inhand walking) which she's took to well, we've got into a good routine. (i arrive 6.15-30 every morning, do the jobs, back at lunch for a quick skip out/hay and water check then back in the evening!) i'm saving lots of money on livery services at least - well not really as its now going on petrol lol

i'm worrying about tonight, the x-rays and everything are done there and then and i think i get shown the results there and then too. so i have every confidence it'll be a thorough investigation. i think even if i wasn't in this situation with my first vets, that a 2nd opinion helps regardless because a fresh pair of eyes can sometimes see or perceive something differently!

my original vets have been dragging their feet about sending the records over to my new vets, after first agreeing to releasing them- then going back on it and trying to convince me to stay as a client.

i'll update tonight hopefully with something positive or at least something I can work with. :S xx

 

[Pinkvboots]

apologies for the delay in replying x

midlifecrisis- she kicks the door occasionally, that's a good point- thank you

SEL - thank you, I think its kind of the same for my yard - half use my first vets and half use the ones i'm changing to!

Lady Jane- i'm based in cheshire, yes have chosen new vet

brighteyes - I know what you mean, but i didn't want any hassle and just paid what I owed- they are trying

Pearlasinger - that's a good shout, i'll make a note of that in my phone so I don't forget.

--

the vet is coming around 4pm this afternoon so fingers crossed, i've kept her fully box rested the past few days (no inhand walking) which she's took to well, we've got into a good routine. (i arrive 6.15-30 every morning, do the jobs, back at lunch for a quick skip out/hay and water check then back in the evening!) i'm saving lots of money on livery services at least - well not really as its now going on petrol lol

i'm worrying about tonight, the x-rays and everything are done there and then and i think i get shown the results there and then too. so i have every confidence it'll be a thorough investigation. i think even if i wasn't in this situation with my first vets, that a 2nd opinion helps regardless because a fresh pair of eyes can sometimes see or perceive something differently!

my original vets have been dragging their feet about sending the records over to my new vets, after first agreeing to releasing them- then going back on it and trying to convince me to stay as a client.

i'll update tonight hopefully with something positive or at least something I can work with. :S xx

Fingers crossed for later honesty your vets sound terrible how dare they try and withhold your records and try and get you to change your mind, I think I would be tempted to make a complaint about them.

 

[Midlifecrisis]

I ll be thinking of you this afternoon and hope further progress is made.

 

[CanteringCarrot]

I'd not use the first vet ever again if I could help it! It's also 2021. Mobile x-ray machines are a thing and quite capable onsite. You can see and review the x-ray right there. Unless you live very rural and only have a "farm vet" but in the UK, this isn't so common.

Having the records would be useful, but not the end of the world if they don't come through. However, I think it is totally wrong to withhold them. A second opinion and fresh eyes seems beyond valuable at the moment.


Best of luck at the appointment later.

 

[Sossigpoker]

My horse went hopping lame and had heat in the foot. No puss after treating for abscess for 5 days. Then nerve blocked to confirm lameness to the hoof and xrayed but that was inconclusive . So we went for an MRI which showed a DDFT tear like someone else said above.
If your x ray doesn't show anything and the lameness is blocked to the hoof I'd be inclined to ask for an MRI referral.
Your old vets sound absolutely awful!! Once you've got a bit further with the investigations I'd be writing a detailed complaint to them about their many failures.

 

[throwawayaccount]

Thanks everyone for the replies x

feeling a bit drained and defeated. The vet came, he was really nice and honest and immediately said he didn’t want me spending my money more than necessary. Walked/trotted her up and lunged her, dog lame

He commented her back legs didn’t look right and the right fore was most predominant so to concentrate on that

he told me she was in pain and I burst into tears as I’ve never thought of it that way. “A bit uncomfortable” my old vets described it. I’ve thought recently she was rather uncomfortable, but in pain? It’s like a new level, just as it’s worded differently. We went ahead with nerve blocking and she improved then went lame again.

I asked if we can get her sound enough to be a field horse and he hopes so.

options-

1. MRI £1100 to give a true picture. We both think it’s DDFT as suggested by a couple posters here. . I have to pay for this as sadly my vets opened a claim last year for Palmer foot pain and my insurance won’t pay out as a result (I rang tonight to check). I can sell my saddle and other bits to fund it as I’ve depleted my savings these past 2 weeks on vet bills and my car. I could possibly ask my boyfriend to help or ask the vets if I do a payment plan - I’ve already spent 5 figures on her vetbills and I’m now skint vetbill wise. I’m not rich and literally have thrown everything I can at Her

2. heart bar shoes and 3 month rest then sick paddock. Not really an option as tbh I don’t think it’ll do much and she hates the sick paddock

3. My option, turn out and let her be a horse then pts before winter.

Honestly feeling Really sad. Sorry for typos - typing on phone and it’s glitching due to low battery.

 

[throwawayaccount]

Double replying to add(can’t edit on phone). I don’t know much about DDFT- it sounds very final. I haven’t googled too much as not sure I can cope at this moment

 

[Roxylola]

If you spend the £1100 on MRI, get confirmation of what you and the vet both think, what difference does it make to option 2 or 3 being the way forward? Spending 4 figures on diagnosis doesn't change treatment or prognosis and it doesn't make you a bad owner for not wanting to pursue it. I think my route would be 3 if I could get her comfortable for a month or two

 

[throwawayaccount]

If you spend the £1100 on MRI, get confirmation of what you and the vet both think, what difference does it make to option 2 or 3 being the way forward? Spending 4 figures on diagnosis doesn't change treatment or prognosis and it doesn't make you a bad owner for not wanting to pursue it. I think my route would be 3 if I could get her comfortable for a month or two

That’s a good point honestly, I’m just trying to work out the right thing to do. I feel utterly selfish for even considering 3 and I think I’d probably guilt trip myself forever over it. I know I’ve only had her a year and a half- almost anyway- but she’s truly my best friend.

 

[fredflop]

It would be number 3 for me. I think unfortunately in some circumstances we just end up spending more and more money with the vet and there’s just no end to the problems.