Lameness workup

[Amye]

Apologies in advance for the newbie question (and I know it's asked quite a lot), but I'm just after some advice as I've never had a lame horse before (or one that's not come sound after a few days rest).

So, my boy went unsound a week or so ago, didn't feel right when ridden but didn't look majorly lame, just a bit unsound in trot. I gave him a few days off and then looked again, but he was still unsound. I then put him on box-rest and now he's been on box rest for a week or so (I've been hand grazing him for half an hour morning and afternoon). His fetlock was swollen for the first couple of days but it has since gone down and is now only slightly swollen. i was hoping he'd come right with rest but no luck. Had the vet out today to look at him, she has given me some bute to try him for a week and if no good then he'll need a lameness workup. TBH I think he'll need a workup anyway. She reckons it might be his tendon But she did say he's only slightly lame.

I asked about just doing the lameness workup straight away, as he's already been rested for a while, and she said I could do but still sort of said 'see how he goes'. So I'm not sure what is best? A weeks rest isn't going to do any harm I guess? Is bute going to change it that much in a week?

Also, I have a question about the lameness workup. She said he would probably have to go in for the workup, but she admitted she was new to the practice so wasn't sure. I spoke to some others on the yard and they said they the vets can do x-rays and stuff at the yard but for nerve blocks etc he needs to be at the vets. So they'd prefer him to be there probably but they could do some stuff at the yard. Do you think it would be best just to take him to the vets and get it all done in one go? Or could I have some stuff done at the yard, see the results, and then, if needed, take him to the vets? The reason I ask is he's not a great loader so would prefer not to travel him unless necessary (he is actually fine once in it's just getting him in!) but he will load so I could do if needed. I just don't want him to prat about and do himself more injury!!


Sorry for the long post. He's my first horse so I'm a bit novicey with all this and a bit worried I feel like I should have got the vets sooner but so many people were giving me advice I didn't know what to do for the best.

Any advice on insurance too? Do I just speak to the vets about what to do about going through insurance if he does need the workup? I'm not sure if they contact the insurers or if I have to (never had to do it before!)

 

[Alibear]

Hi, didn't want to read and run. Its always hard to know what to do for the best when things go a bit wrong, it sounds like you've taken sensible steps so far.
You can have the vet come out and do some diagnostics as the yard as long as they have mobile x-rays etc if you want.
It's becoming more common to box up to a specialist equine vets where they have all the facilities on site to investigate what ever is found, its popular terms of getting a quicker diagnosis and treatment. It can also save on multiple call out fees that you might build up with them coming out to you and then needing different kit etc. so having to come back another day.
Neither is the best option its more a case of what suits you. Even at the specialist vets they might then want an MRI and send you off somewhere else an other day!
Usually a lameness work up starts with nerve blocks and they work there way through in a certain order so the one that makes the horse sound identifies where the problem is.
However as you already have good indicator of the problem they might start straight there.
In your situation I'd ring the vets and ask what my options were.
With regards insurance, you are supposed to tell them every time the vet sees your horse under the policy conditions regardless or whether you claim or not. You usually have a set time to do that too.
So probably worth just dropping your insurers and email explaining the above, if not and you do need to claim in future for something; they may ask your vets for the horses full history which will show the above and could cause issues.
Good luck.

 

[Goldenstar]

It’s best done at the vets it’s much more efficient .
From what you have posted it’s likely the horse will need diagnostic scanning not X-rays .
If he’s clearly lame on one leg and there is swelling it’s inlikely to need nerve blocks .
I would lce the leg If the horse where mine .
I would not be doing any work or turn out until you know what’s wrong you risk making a minor injury a much more serious one .

 

[Amye]

Thanks for both your replies Feeling a bit calmer now! Looks like I might have to bite the bullet and go to the vets - if they're thinking tendon I don't really think X-rays will show much! I think I will ring them and see what they say.

Thanks for the tip with the insurance! he's only had his vaccinations before so I didn't know we had to inform them of each visit.


Thanks I'll start icing it. Don't worry - he's on box rest until we know what the problem is!

 

[ycbm]

Nerve blocks can be done at home. The only things I can think of for a lameness workup that can't be done at home are ones that need the big machines, MRI and scintigraph.

 

[ester]

Generally it's easier to keep things clean when injecting joints at the vets, some vets prefer it more than others IME. But if you have/had a swollen fetlock you have a starting point anyway.

They can also usually take better images with their in house kit - I know with mine their portable xray is ok but not amazing or as good as some other practices and it's just easier if it is all in one place. If you aren't sure what you are looking at (ie whether you want ultrasound or the xray machine in the boot of the car.
Also more hands on deck when your pony decides to be an idiot (in fairness to him he may have been less of an idiot at home and not require 3 handlers to be sure nerve blocked hoof stayed on the floor :rolleyes3:.


Re. waiting it doesn't usually do any harm other than us worrying! though does depend a bit on the horse, we have one prone to the odd leg bash which will cause swelling and a bit of lameness but always settles so wouldn't rush with her for instance.

 

[Pinkvboots]

Sorry your horse is lame just wanted to say quite often once they pin point an area with nerve blocks they will x ray and scan just in case there is more than one thing going on, just so they can rule out things mainly they will sometimes do the same with the other opposite leg depending on what they find as they will compare the images of both limbs, fingers crossed it's nothing too serious.

 

[Amye]

Thank you all for your replies It's nice to know a bit more what goes on! I guess I'll have to speak to the vet to see if they want him in or are happy to do it at home. I've been thinking about it and thinking it would be easier to get someone else to load him (hire a box with a driver who's used to sticky loaders), might cost a bit more but if I'm stressed I don't think it will help getting him on the box so someone who isn't going to stress out would be best haha.


I don't know if any of you have any insights on this but, yesterday the vet said I could still walk him out for a bit (morning and afternoon), I just let him go have a graze, not far or fast. But, speaking to some people at the yard, they were surprised they said I could walk him and thought he'd need to be on strict box rest if they suspect a tendon? I haven't walked him this morning and am waiting a cal back from the vet to clarify what she said.

Would you walk him out or just leave him in?

 

[Auslander]

Thanks for both your replies Feeling a bit calmer now! Looks like I might have to bite the bullet and go to the vets - if they're thinking tendon I don't really think X-rays will show much! !

An ultrasound scan will though. Personally, I am happy for my vet to do lameness workups, including nerve blocks/scans and xrays, at home. I'd only box over to the clinic if nothing was obvious at that point. My vet has never failed to make a diagnosis when investigations have taken place here.

 

[ycbm]

An ultrasound scan will though. Personally, I am happy for my vet to do lameness workups, including nerve blocks/scans and xrays, at home. I'd only box over to the clinic if nothing was obvious at that point. My vet has never failed to make a diagnosis when investigations have taken place here.

I have deliberately moved to a vet with no hospital. The problem gets identified at home and then referred to a specialist in that issue. If it can't be identified, then the big machines get used, but only if it will actually change the treatment plan, which is always a question worth asking before hand of you are not insured.

At your stage OP, I certainly wouldn't be paying to hire a box and driver for a whole day and risking a sticky loader making an injury worse - twice, on leaving and returning.

To answer your other question I would walk him for a pick of grass but only if he is absolutely quiet.

 

[be positive]

I have deliberately moved to a vet with no hospital. The problem gets identified at home and then referred to a specialist in that issue. If it can't be identified, then the big machines get used, but only if it will actually change the treatment plan, which is always a question worth asking before hand of you are not insured.

At your stage OP, I certainly wouldn't be paying to hire a box and driver for a whole day and risking a sticky loader making an injury worse - twice, on leaving and returning.

To answer your other question I would walk him for a pick of grass but only if he is absolutely quiet.

I would also start at home if the vet thinks ligament or tendon, which they should be able to feel by palpation, then a nerve block and scan to confirm would make sense, only if nothing shows would a full work up be required, they do seem to rush everything in for full diagnostics given half a chance.

 

[milliepops]

what do you have at home in the way of facilities OP? Only asking because I've taken horses in for work ups and they have wanted to lunge on hard and soft surfaces. We only have stony hardstanding at home and we aren't allowed to lunge in the school :rolleyes3: so absolutely no point trying to do it at home.

Just in case, as others have said you have a good starting point so this might not be relevant but thought I'd mention it.

 

[ester]

If you've not got transport it makes sense to do what you can at home first, easy enough to scan a tendon.

MP yes that is partly why F went in, we have a field so lungeing is whatever the ground conditions happen to be that day!

 

[Amye]

Ahhh ok thank you everyone! That makes it all a bit clearer in my head.

Sounds a bit stupid but I didn't realise they could do so much at home. And the vet yesterday was new so she thought he'd have to go in. I don't really want to travel him unless I have to, as you've said, I don't want to make it worse!


Milliepops - We can lunge in the school and we do have concrete over the yard so you could lunge on that I guess! It's not stony and pretty flat.

YCBM - He is normally a quiet steady boy. We have a few 'spooky' places on the yard but I could avoid them quite easily.


ETA: I can't work out how to multi-quote so apologise for not quoting you all.

 

[sanjo]

Ahhh ok thank you everyone! That makes it all a bit clearer in my head.

Sounds a bit stupid but I didn't realise they could do so much at home. And the vet yesterday was new so she thought he'd have to go in. I don't really want to travel him unless I have to, as you've said, I don't want to make it worse!


Milliepops - We can lunge in the school and we do have concrete over the yard so you could lunge on that I guess! It's not stony and pretty flat.

YCBM - He is normally a quiet steady boy. We have a few 'spooky' places on the yard but I could avoid them quite easily.


ETA: I can't work out how to multi-quote so apologise for not quoting you all.

 

[sanjo]

Did you ever find out what was wrong by taking the horse to the vet hospital? Reading with interest, even tho it was several years ago...