Lameness! Inter osseous ligament.

[Belle22]

I moved yards with my horse turning her out the same day. The next morning she was lame.
I had both my farrier and a physio out to see her but neither found a reasons for the lameness.

I contacted my vet and after 4 sessions (one being the initial call out) we still have no solid ideas.
She's had nerve blocks from below the knee down and the only conclusion is that it's not her foot.

We repeated some blocks as she only came sound when a block was given below the knee. We took xrays & scans of the area and aside form a distortion that the vet seems to think is due to the block, we found nothing to suggest a reason.

I requested for another vet to look and she found distortion between the splint and cannon bone ie the inter osseous ligament.

We did a specific nerve block based on this but she still came up lame. so we tried to block the whole leg from knee down again, which this time only improved her by 60% ish as she was being difficult when given the block.

So even though the specific block didn't work the vets are still treating it as though its that area with shockwave therapy.

I am just wondeirng what people think about this, do you think it's contradictive or is it just me.

I am also have problems when it comes to touching her sholder/elbow are, she isn't happy when I put pressure on it, as she tries to bite etc and evn to kick the physio which is out of character, but the vet hasn't even checked over the area.
Is the vet right to do this??

Sorry for the long winded essay, I would just like peoples thoughts...

Also, if anyone has any knowledge of this id be grateful to hear.

 

[debsflo]

sorry prob not much help but similar situation with my horse and vets cant pin point seat of lameness. i am worried sick so will probably ask for referral to rossdales or similar for detailed investigations as until you know what it is youre fumbling around in the dark .would that be an option for you . i realise their are costs involved .i am insured but still have to pay first £500.

 

[alsiola]

We repeated some blocks as she only came sound when a block was given below the knee.

We did a specific nerve block based on this but she still came up lame. so we tried to block the whole leg from knee down again, which this time only improved her by 60% ish as she was being difficult when given the block.

60% improved is enough to say the block has worked in my eyes - don't necessarily expect to see 100% resolution of lameness.

If the lameness has blocked to a sub-carpal level, then I think your vet is right to ignore the shoulder from a lameness point of view, although there may be other issues higher up, they have proved they are not related to the lameness.

Lameness that blocks to sub-carpal blocks can be challenging - there was some research presented at an equine conference earlier this year that showed that a significant number of sub-carpal blocks will also numb the lower carpal joints, and that a significant number of carpal joint blocks will also numb the suspensory ligament (/interosseous ligament). In short, it is very difficult to distinguish between lower carpal joint problems and high suspensory injuries.

I would be tempted to block the carpo-metacarpal joint and see if this improves the lameness. This may not do any more than make the picture even cloudier though. MRI is another option, which can only be performed this high up the leg in a few places in the UK, and still might not give you an answer!

I would definitely be doing shockwave to the SL, and depending on the response to a carpo-metacarpal joint block would be tempted to medicate the joint as well (with steroids + artificial joint fluid).

 

[xxMozlarxx]

Blimey!! ^^^^^ I presume you are a vet and want us to know you are but to be honest its not much good if we cant understand what you are talking about!!

 

[Belle22]

60% improved is enough to say the block has worked in my eyes - don't necessarily expect to see 100% resolution of lameness.

The part I'm unsure of is she was only sound when the full leg was blocked. We did this on friday and she was 100% sound. Based on this and what the other ver saw on the xrays near the inter osseous ligament, we then did another block on the inside of the leg only, (so half a block) to attempt to target this issue.

This specific block made no difference, she was still as lame.

We then blocked the whole again to try to mimic the results of 100%soundness from fri. Though not 100% better at most 60% better.

So my thoughts are... if the specific block on the inside of the leg (with the inter osseous ligament in mind as the problem) showed no improvment, but the full leg block did, why are the vets still targeting the inside of her leg?

Thank you for the thoughts/advice though Alsiola, it is deffinatly worth mentioning to my vet when she next comes.