MRI for diagnosis?

Michen

Michen

Well-Known Member
Joined
22 January 2014
Messages
12,812
Visit site
Hi all,

Without getting into too much detail (some of you must be seriously bored of me on here by now), my ex racer who I've had for nearly four months is very much not right in front. He's had x rays and remedial shoeing but both vet and I are in agreement that its likely there is a bit more going on than what we've seen on x rays. Anyway, in my 15 years of horse ownership I've somehow escaped all of this diagnostics stuff so this is new territory to me. I've come to the decision to send him in to the vets for full investigation into his front feet, and a lameness work up of his back end (a few niggly symptoms there) as I need to know whether this horse is ever going to be sound or whether I need to PTS. This is obviously really sad and stressful.

He's insured, and the insurance company have paid out for everything with regards to his feet so far. Initially they will be nerve blocking etc, but I've said to the vet that if there is a high chance they will want to MRI then I want them to book him in now so that I don't have to take him away again and bring him back when finding transport is a struggle.

Quite frankly, there's £4500 of insurance money left on this issue and I'm happy for them to do whatever it takes to get a diagnosis.

However I just want to make sure I am barking up the right tree here- from what I understand MRI is absolutely the best way to get a diagnosis- over ultrasound? I don't really understand the ins and outs of it but I just want to make sure that this is the right route to be going down to look at tendons and ligaments etc? What does it do that an ultrasound doesn't? Rookie with this stuff!
 
I am sure that no-one minds at all, you are obviously an extremely caring owner, I just hope your boy comes right :)

I had a horse that stood on a nail, after a week of no progress at horsepital they assured me that an MRI would tell them all - ultimately they still couldn't give me a definitive answer, I think it cost nearly £2,000 for the scan. I would say that if you have plenty of lee-way on the insurance then go for it, just be prepared that it may not give you all the answers you need - have everything crossed that you find a solution.
 
some of the equine hospitals do a fixed price for MRI now. My local equine hospital, for example, charge just under a £1000 for both front feet. I have been unfortunate during my horse owning "career" to have two horses go through an MRI, one very recently. I agree with GS that although they generate information - they are not necessarily conclusive. For example, if there is an obvious tear in a ligament then clearly they can see it on an MRI but if it is a thickening whilst they can see it they don't know whether the horse has always had that - if that makes any sense? just as you and I are not "perfectly formed" on the inside it is a case of trying to see what the horse has always coped with and what might be the current cause of the lameness. My old boy showed up a tear in his DDFT but because it looked healed they treated the suspensory desmitis instead! And they can't see any very deep bruising in the foot. So it does give them information but in my (limited) experience the ultimate diagnosis was a "we think, on balance, this is what is causing the current lameness" rather than anything more definitive. Good luck!
 
The good thing about having an MRI done is that it shows up soft tissue stuff like the DDFT and Navicular Bursa, whereas the x-rays that you had done before obviously only show up bones/joints. My horse recently had his front hoof MRI'd at a cost of £1200 resulting in confirmation that his DDFT was fine but that he had other issues going on. Like any diagnostic tool, it's all about interpreting the results so as to find the "most probable cause" of the problem, rather than an absolute black and white answer. It sounds like your little horse has multiple issues Michen - depending on who you are insured with, you may be able to open mulitple claims if they are unrelated. I am with NFU and currently have three claims open (hind end, front leg, front hoof), all with a cap of £5k each. My vets are overjoyed.
 
Fun Times said:
The good thing about having an MRI done is that it shows up soft tissue stuff like the DDFT and Navicular Bursa, whereas the x-rays that you had done before obviously only show up bones/joints. My horse recently had his front hoof MRI'd at a cost of £1200 resulting in confirmation that his DDFT was fine but that he had other issues going on. Like any diagnostic tool, it's all about interpreting the results so as to find the "most probable cause" of the problem, rather than an absolute black and white answer. It sounds like your little horse has multiple issues Michen - depending on who you are insured with, you may be able to open mulitple claims if they are unrelated. I am with NFU and currently have three claims open (hind end, front leg, front hoof), all with a cap of £5k each. My vets are overjoyed.
Click to expand...

Oh blimey, whats the outlook for your horse? I just got so cross today because the receptionists were saying "well if the vet decides to MRI you will have to take him away and book him in and bring him back" and I rang my vet and just said BLOODY BOOK HIM IN AND USE THE INSURANCE MONEY I DON'T CARE!!!!!! I just want an answer! And I have to rely on other people to taxi him to and from the vets so its just silly.
 
Fun Times said:
The good thing about having an MRI done is that it shows up soft tissue stuff like the DDFT and Navicular Bursa, whereas the x-rays that you had done before obviously only show up bones/joints. My horse recently had his front hoof MRI'd at a cost of £1200 resulting in confirmation that his DDFT was fine but that he had other issues going on. Like any diagnostic tool, it's all about interpreting the results so as to find the "most probable cause" of the problem, rather than an absolute black and white answer. It sounds like your little horse has multiple issues Michen - depending on who you are insured with, you may be able to open mulitple claims if they are unrelated. I am with NFU and currently have three claims open (hind end, front leg, front hoof), all with a cap of £5k each. My vets are overjoyed.
Click to expand...

Oh had to add... he's had three claims in three months of insurance with him! Petplan equine, one for an over reach boot rub which got seriously infected and wouldn't respond to treatment (£400), Ulcers (at £1300 currently) Feet (£450 and that's just the beginning).

I almost feel bad and then I remind myself that I've paid these people for years before without claiming a single penny!
 
Firstly I apologise for the following essay!

I had mine MRId for intermittent lameness. Like you I had insurance money 'left' to do it and vet was supportive. I like to know what I am dealing with and it really does show up what's happening.

I had 2 issues with it, the first is being my horse only showed mild intermittent lameness on right fore, MRI showed up v mild inflammation in the nav bone itself and bodies in the bursa fluid on the right fore and a trace of inflammation with no bodies in bursa fluid on left fore. Even though I had no issues with the left it is now excluded on insurance along with the right due to the MRI result. I don't know if they would have excluded without this on the grounds that problems like this can turn out to be bilateral?

The second issue is that as my vet says it is not a measure of pain and so the results are still subjective to careful interpretation. I was pretty upset after speaking to the consultant who started off by saying nothing much to see, fairly standard for a 10 year old warmblood- diagnosed remedial shoeing and Tildren and then went on to say that the horse should stay sound for 2 years.....I was imagining 2 years of waiting for G to go crippled and then having a properly broken horse at the age of 12. After speaking to my own vet who knows the horse, the situation and his lifestyle, we decided on Tildren (insurance paying!) and shoe removal. My vet reckoned that with such mild signs, being discovered so early he wouldn't actually expect that many problems in the future as long as I was sensible and didn't hammer him around.

The first part of barefoot rehab (done at home with no facilities) was easy and then we had a few abscess issues. He was fab last summer and feet are looking great, but I have struggled this winter- my fields are clay and underwater, I am pregnant and can't get the work into his feet so we have decided (long with trimmer, vet and farrier) to shoe for a couple of cycles and then take them off again when conditions re better. He is actually feeling amazing at the moment and although I am still riding, he has become a bit bouncy for my big old pregnant belly and so I probably won't be able to ride him much longer. I will then remove shoes when not in work, and put them back on again if he needs them in the summer when he is back in full work. I am aiming for the best of both worlds, will be interesting to see if it works out!

So I am very glad that I MRId but it may have opened a can of worms. However I think if I hadn't had the diagnosis and had carried on I would have had bigger issues further down the line.

Sorry for the essay but I do fully understand that horrid despair feeling! There is hope but I m very glad that I did MRI and also that I took Gs shoes off 18 months ago.
 
avthechav said:
Firstly I apologise for the following essay!

I had mine MRId for intermittent lameness. Like you I had insurance money 'left' to do it and vet was supportive. I like to know what I am dealing with and it really does show up what's happening.

I had 2 issues with it, the first is being my horse only showed mild intermittent lameness on right fore, MRI showed up v mild inflammation in the nav bone itself and bodies in the bursa fluid on the right fore and a trace of inflammation with no bodies in bursa fluid on left fore. Even though I had no issues with the left it is now excluded on insurance along with the right due to the MRI result. I don't know if they would have excluded without this on the grounds that problems like this can turn out to be bilateral?

The second issue is that as my vet says it is not a measure of pain and so the results are still subjective to careful interpretation. I was pretty upset after speaking to the consultant who started off by saying nothing much to see, fairly standard for a 10 year old warmblood- diagnosed remedial shoeing and Tildren and then went on to say that the horse should stay sound for 2 years.....I was imagining 2 years of waiting for G to go crippled and then having a properly broken horse at the age of 12. After speaking to my own vet who knows the horse, the situation and his lifestyle, we decided on Tildren (insurance paying!) and shoe removal. My vet reckoned that with such mild signs, being discovered so early he wouldn't actually expect that many problems in the future as long as I was sensible and didn't hammer him around.

The first part of barefoot rehab (done at home with no facilities) was easy and then we had a few abscess issues. He was fab last summer and feet are looking great, but I have struggled this winter- my fields are clay and underwater, I am pregnant and can't get the work into his feet so we have decided (long with trimmer, vet and farrier) to shoe for a couple of cycles and then take them off again when conditions re better. He is actually feeling amazing at the moment and although I am still riding, he has become a bit bouncy for my big old pregnant belly and so I probably won't be able to ride him much longer. I will then remove shoes when not in work, and put them back on again if he needs them in the summer when he is back in full work. I am aiming for the best of both worlds, will be interesting to see if it works out!

So I am very glad that I MRId but it may have opened a can of worms. However I think if I hadn't had the diagnosis and had carried on I would have had bigger issues further down the line.

Sorry for the essay but I do fully understand that horrid despair feeling! There is hope but I m very glad that I did MRI and also that I took Gs shoes off 18 months ago.
Click to expand...

Thank you for the essay it's appreciated :) firstly how come they MRId both feet? Mine is bilaterally lame so assuming both will be looked at but just curious. What was your actual diagnosis as such and why did you decide to remove the shoes? I am thinking about the shoe removal route but I have an incredibly flat footed thin soled horse and our fields are a mess at the moment!
 
I *think* it's standard to compare between the two- and I think that mostly these things do turn out to be bilateral....certainly the other two horses that I have known MRId for front lameness had both done.

So actual diagnosis was mild inflammation of the right navicular bone, with bodies in the bursa on the right fore, and traces of Inflammation of the left navicular bone.

This was interpreted by the consultant at Newbury (and my vet) as being inflammation of the nav bone (I didn't even realise that this was a thing) due to the start of damage to the bone because of pressure exerted over a period of time by poor foot balance (speculation obviously) and tension on the DDFT. The bodies were concluded to be fragments of DDFT fibre where the tendon had started to wear on the inflamed nav bone. The pain G was experiencing a was speculated to be due to the mild damage to the DDFT....interestingly there was very little to be seen on the DDFT itself so both vets concluded that G is a bit of a big ginger wuss with a very low pain threshold. In many ways I think this is a blessing as it showed up the signs of damage before it (hopefully) became a massive problem. All his previous feet X-rays were normal.

I decided to remove the shoes as I feel that shoes can be used to mask the pain and make it better for a while but doesn't actually change the issue which is the Relationship between the DDFT and the nav bone. By allowing the feet to change shape rather than changing the shape to what we think they should be the back of the foot builds up and the pressure of the DDFT is reduced. I have no idea if this is actually correct, all I know is that G was mildly, irritatingly intermittently lame for a year with shoes on feet with long toes and underrun heels. Following shoe removal his feel changed shape dramatically, much beefier and stronger back of foot, shorter toe and much more upright looking and although I have has abscess issues I have not had the same irritating lameness for 18 months (who knows if this will continue!).

When I win the euro millions I am going to build a MRI machine and offer free MRI scans to all people who have had lameness issues and MRI diagnosis to compare before and afters so that we finally know for sure!
 
avthechav said:
I *think* it's standard to compare between the two- and I think that mostly these things do turn out to be bilateral....certainly the other two horses that I have known MRId for front lameness had both done.

So actual diagnosis was mild inflammation of the right navicular bone, with bodies in the bursa on the right fore, and traces of Inflammation of the left navicular bone.

This was interpreted by the consultant at Newbury (and my vet) as being inflammation of the nav bone (I didn't even realise that this was a thing) due to the start of damage to the bone because of pressure exerted over a period of time by poor foot balance (speculation obviously) and tension on the DDFT. The bodies were concluded to be fragments of DDFT fibre where the tendon had started to wear on the inflamed nav bone. The pain G was experiencing a was speculated to be due to the mild damage to the DDFT....interestingly there was very little to be seen on the DDFT itself so both vets concluded that G is a bit of a big ginger wuss with a very low pain threshold. In many ways I think this is a blessing as it showed up the signs of damage before it (hopefully) became a massive problem. All his previous feet X-rays were normal.

I decided to remove the shoes as I feel that shoes can be used to mask the pain and make it better for a while but doesn't actually change the issue which is the Relationship between the DDFT and the nav bone. By allowing the feet to change shape rather than changing the shape to what we think they should be the back of the foot builds up and the pressure of the DDFT is reduced. I have no idea if this is actually correct, all I know is that G was mildly, irritatingly intermittently lame for a year with shoes on feet with long toes and underrun heels. Following shoe removal his feel changed shape dramatically, much beefier and stronger back of foot, shorter toe and much more upright looking and although I have has abscess issues I have not had the same irritating lameness for 18 months (who knows if this will continue!).

When I win the euro millions I am going to build a MRI machine and offer free MRI scans to all people who have had lameness issues and MRI diagnosis to compare before and afters so that we finally know for sure!
Click to expand...

This is so useful, thank you for taking the time to write all this out! I'm guessing your boy went to Donnington, which is where mine is off to. Luckily its only 6 miles down the road and given he's currently refusing to load I may just end up hacking him down the a34 ;)
 
You must log in or register to reply here.
Top