Medicating the bursa/coffin joint

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Moomin1

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My 16.3hh 15yr old mare has been bilaterally lame on her fores since May this year. She's been on long term box rest which brought her sound, until she started very gradual work again. Next step is to medicate the bursa/coffin joints. Her x rays are all showing clear so it's more likely a soft tissue problem. MRI is out of the question unfortunately due to finance. Would be interested to hear others experiences of medicating the bursa and how effective it was long term.
 
Pulled directly from my horses vet report when he had his bursas injected:

The documented success following navicular bursa medication is for 80% of horses to come sound, for 7 – 12 months, though up to 15 months after six months of rest.

So frankly it's a sticky plaster on a problem isnt it? I'd be doing a barefoot rehab if I were in that situation again. I assume you have had nerve blocks done to locate where the lameness is coming from in her fores.
 
My mare had arthramid injected in her coffin joint 6 weeks ago. Her x Ray's were clear too, nerve blocks isolated issue to coffin joint. Unfortunately it hasn't helped her and she is having shoes off and an mri scan next week.
 
My gelding has been diagnosed with navicular bone deterioration, collateral ligament damage, navicular/ coffin bursitis and a tear on the DDFT by the navicular in his right fore. MRI at the RVC confirmed the soft tissues issues and the outlook was pretty grim.
After discussion with my own vet we decided to medicate the coffin joint with a short term steroid and HA as he had previously blocked about 99% sound to the coffin joint. At that stage we also discussed barefoot as the potential rehab route and agreed a further review after 2 to 3 weeks to see if the medication had any affect.
At the review 10 days ago he was again 99% sound so we agreed the shoes would come off and we would return a week later to have a follow up medication jab in the joint ( the type of med he had needs 2 doses 4 weeks apart). He had this on Thursday so I can't comment on the long term however I can say that taking his shoes off has made a difference. He was pretty much sound after the first jab but has been walking out better since the shoes came off. His foot has also started to improve - it had become very boxy and upright with a contracted heel and shrunken frog with the prescribed bar shoe.
 
We did, it did help, it only lasted a few weeks and as soon as we commenced more work (ie introducing much trot) he went lame again.
Took his shoes off and he has been sound and hunting for the last 4 years (23 now), stopped this year due to an unrelated hind end issue.

Also nothing to see on xray, given a DJD diagnosis as did block to joint/back of foot but had suboptimal hooves and watching him move I suspect had some collateral ligament damage. Deciding to let him see if he could sort himself out was the best thing I ever did, a decision partly made on the fact that if we couldn't keep him sound he was retiring and there was no need for him to be shod if dossing in the field.
 
Thanks everyone. Barefoot isn't an option. My OH has very kindly offered to pay up to 2k for further tests and treatments so fingers crossed we will get to the bottom of it
 
Moomin1 said:
Thanks everyone. Barefoot isn't an option. My OH has very kindly offered to pay up to 2k for further tests and treatments so fingers crossed we will get to the bottom of it
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Why isn't it an option, moomin?

You don't have statistics on your side if taking the shoes off isn't an option I'm afraid :(
 
ycbm said:
Why isn't it an option, moomin?

You don't have statistics on your side if taking the shoes off isn't an option I'm afraid :(
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I don't really want to get into a barefoot debate lol. It isn't an option and it's agreed with my vet that it would not be an advisable course of action.
 
Moomin1 said:
I don't really want to get into a barefoot debate lol. It isn't an option and it's agreed with my vet that it would not be an advisable course of action.
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There are a lot of owners of dead and permanently retired horses whose vets and farriers gave them the same advice :(

If your mare is unsound when they have run out of options, please let us help you through trying a barefoot rehab before you think of retiring or pts.

I hope what they want to do works for her, seriously. Best wishes.
 
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Moomin1 said:
Thanks everyone. Barefoot isn't an option. My OH has very kindly offered to pay up to 2k for further tests and treatments so fingers crossed we will get to the bottom of it
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Err, why isn't barefoot an option?

Fair do's if you've got rock solid reasoning which prohibits attempting a bare foot rehab (which has worked for many horses), but it is only polite to reveal your reasoning, rather than clam up and say its impossible, seeing as you are the one asking for advice.
 
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Tiddlypom said:
Err, why isn't barefoot an option?

Fair do's if you've got rock solid reasoning which prohibits attempting a bare foot rehab (which has worked for many horses), but it is only polite to reveal your reasoning, rather than clam up and say its impossible, seeing as you are the one asking asking for advice.
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I have my reasons for not wanting to attempt a barefoot transition at this point in time. I didn't ask for advice on barefoot transitions I was asking for experiences of medicating the bursa. I'm fully aware of the benefits of going barefoot with many horses and rest assured if I was to attempt it in the future you guys would be the first I would come to for advice. :) My mare is extremely well loved and I don't take decisions lightly with her.
 
My experiences of bursa medication is that two horses had it done without long term success.

I took the first the day after it was due to be put down and he is in full work five years later.

The second went to Rockley and afaik he is sound as a happy hacker (all that was ever tried) four years later.

I hope it works better for your mare.
 
ycbm said:
My experiences of bursa medication is that two horses had it done without long term success.

I took the first the day after it was due to be put down and he is in full work five years later.

The second went to Rockley and afaik he is sound as a happy hacker (all that was ever tried) four years later.

I hope it works better for your mare.
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Thanks :)
 
My 6y/o Warmblood had the same lameness , X-rays showed nothing but then after 2 months of box rest we had an MRI of both fores which showed navicular, arthritis of coffin joint and inflamed impar ligament (and some DDFT tears but they were the least of our problems) after only having done very limited work up till this point in his life. First steriod injection into the coffin joint brought him mostly sound (plus heart bar shoes) for 6 months till another injection was required, but 2 weeks later went lame again and we booked him in to medicate the bursa, he was on box rest for 4 weeks before the appointment but in the last week I was admitted to hospital so he was put in the field for a few weeks till I came home.
He went out to rest perfectly sound but when I came home he was lame (after simply mooching around the field for 4 weeks), vet decided that medicating the bursa would not have much of an effect and suggested a neurectomy, which we did not go through and ultimately decided to retire him instead.

Not exactly a review of bursa medication but this was my experience of this type of lameness and the recovery (sort of)
Sorry this probably wasn't the positive reply you'd be hoping for - really hope it goes well for you though
 
Well in brief, I lost a beloved horse with this condition after following vet advice. Now I own two barefoot survivors of this condition.
 
Andalucian said:
Well in brief, I lost a beloved horse with this condition after following vet advice. Now I own two barefoot survivors of this condition.
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We don't know what condition she has as of yet. It could be a million and one things. As I've already mentioned, barefoot is not an option so there's little point in anyone mentioning how barefoot has saved their horse. If it was an option for my horse at this time I would be doing it. But it isn't.
 
Moomin1 said:
We don't know what condition she has as of yet. It could be a million and one things. As I've already mentioned, barefoot is not an option so there's little point in anyone mentioning how barefoot has saved their horse. If it was an option for my horse at this time I would be doing it. But it isn't.
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Moomin in I'm sorry, but unless you are prepared to explain why, people will keep saying it. They are saying it because it's the overwhelmingly most likely way to return your horse to soundness. And because they've heard a zillion times, from vets, from farriers, and from owners 'the horse can't go barefoot', when it can.

The fact is, you're unlikely to hear many stories of long lasting recovery by medicating the coffin joint.

Because it doesn't usually work.
 
ycbm said:
Moomin in I'm sorry, but unless you are prepared to explain why, people will keep saying it. They are saying it because it's the overwhelmingly most likely way to return your horse to soundness. And because they've heard a zillion times, from vets, from farriers, and from owners 'the horse can't go barefoot', when it can.

The fact is, you're unlikely to hear many stories of long lasting recovery by medicating the coffin joint.

Because it doesn't usually work.
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I don't need to explain why. If I want advice on going barefoot in future I will ask for it. At this point in time, it is not possible for a few reasons. I don't want a pointless barefoot debate. But thanks everyone for responding. The info about medicating the bursa is noted.
 
Can you share the radiographs? The angles of the feet may provide some clue as to what's going on. If it's a soft tissue injury, obviously it won't show up and those suckers take a long time to heal (thinking back to a completely sheared collateral ligament in a horse who had very upright feet, only symptom was suddenly uncontrollable when turning right as the response to pain was "SPEED UP!"... horse had a year off and PRP/stem cell treatment and very controlled return to exercise.)
 
Friend's horse, think he was late teens at the time, was on off slightly lame in front. He was MRId with impar ligament inflammation. No other soft tissue issues. He had 2 lots of injections into the coffin joint and came sound and stayed sound for a few years, he never jumped again tho and he'd been out eventing up to 90/100.

He is retired now due to breathing problems but is still sound, however he isn't shod anymore because the heart bar shoes that were prescribed for the ligament damage had basically wrecked his feet when they were left on far too long so his shoes were taken off, feet are great now.
 
ohmissbrittany said:
Can you share the radiographs? The angles of the feet may provide some clue as to what's going on. If it's a soft tissue injury, obviously it won't show up and those suckers take a long time to heal (thinking back to a completely sheared collateral ligament in a horse who had very upright feet, only symptom was suddenly uncontrollable when turning right as the response to pain was "SPEED UP!"... horse had a year off and PRP/stem cell treatment and very controlled return to exercise.)
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Yes the angles of the feet/hoof balance have already had a lot of work done and vet is happy with how they are now, though slight bit of work still left to be done. X rays otherwise completely clear. Nerve blocks pinned it down to within the feet. Lami ruled out. Navicular x rays clear.
 
AnShanDan said:
Friend's horse, think he was late teens at the time, was on off slightly lame in front. He was MRId with impar ligament inflammation. No other soft tissue issues. He had 2 lots of injections into the coffin joint and came sound and stayed sound for a few years, he never jumped again tho and he'd been out eventing up to 90/100.

He is retired now due to breathing problems but is still sound, however he isn't shod anymore because the heart bar shoes that were prescribed for the ligament damage had basically wrecked his feet when they were left on far too long so his shoes were taken off, feet are great now.
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Thanks, that sounds hopeful. If we can so much as give her another couple of years I will be very happy. Not fussed if she doesn't jump again so long as we can do low level flat work etc. :)
 
Moomin1 said:
Yes the angles of the feet/hoof balance have already had a lot of work done and vet is happy with how they are now, though slight bit of work still left to be done. X rays otherwise completely clear. Nerve blocks pinned it down to within the feet. Lami ruled out. Navicular x rays clear.
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I hope your vet has explained to you that the condition of the navicular bone on radiographs usually bears no relationship to whether a horse is lame? In any case, the radiographs are clear, so you know you are dealing with a soft tissue problem, which is normal for long term foot lameness.
 
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ycbm said:
I hope your vet has explained to you that the condition of the navicular bone on radiographs usually bears no relationship to whether a horse is lame? In any case, the radiographs are clear, so you know you are dealing with a soft tissue problem, which is normal for long term foot lameness.
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Yes. Im fully aware of that. I was just pointing out what tests had already taken place and shown. We have been aware its a soft tissue problem since day dot.
 
Sounds slightly similar to my sisters horse. Unfortunately she's still lame. Nerve blocked lame to the foot. X rays clear (a little issue around coffin joint but no improvement when medicated) started off with bar shoes which made her worse. She's had shoes off for over a year now. Still lame and on daily danilon until this no longer works for her. It's heart breaking. Ultimately, we don't know what is wrong with her except that it's soft tissue. She needs an mri which is probably just going to reveal some deep tissue damage with guarded, if any prognosis, after all, she's had years of field rest at this point. I hope you have better success, I think ours is a particularly bad example!
 
Field rest does not work for some of these horses. The problem is usually caused by weakness in the heels, which does not improve without stimulation. I took on one that had been extensively field rested, then retired completely and he was still lame. I got him out on the road, walking walking walking, and he came sound in three months.

Is your sister's horse toe first landing?
 
googol said:
Sounds slightly similar to my sisters horse. Unfortunately she's still lame. Nerve blocked lame to the foot. X rays clear (a little issue around coffin joint but no improvement when medicated) started off with bar shoes which made her worse. She's had shoes off for over a year now. Still lame and on daily danilon until this no longer works for her. It's heart breaking. Ultimately, we don't know what is wrong with her except that it's soft tissue. She needs an mri which is probably just going to reveal some deep tissue damage with guarded, if any prognosis, after all, she's had years of field rest at this point. I hope you have better success, I think ours is a particularly bad example!
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Thanks Googol. Sadly I think it's very much similar. I've decided to retire her gracefully and she's going to be moving to grass livery round the corner from my house which is lovely. I won't be riding for a long time anyway due to personal circumstances so I will reassess her lameness issues in a years time when I'm personally able to ride again and take things from there. (And before anyone mentions it, I won't be taking her shoes off lol)
 
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