MRI Results - bad news - DDFT - any experience?

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nic83

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I apologise in advance for the long post, but I need any help/advice possible

My horse went lame at the end of January this year, he went to the vets and was about 5/10 lame. His heel was nerve blocked and he improved. Feet were X rayed and he had broken back hoof pastern axis, in both feet. (worse in the right, though he was lame on the left)

We started remedial showing with wedges to improve the angle. He came sound again, but as in hand work began he went lame again. We went back to the vets early May, he was still lame but only about 2/10. He had a nerve block to the navicular bursar and again improved. On this basis the navicular bursar was medicated and he had Tildren.

He was referred for an MRI and the results are not good. In summary he has:
• Bi lateral mild navicular disease (worse in left fore)
• Deep Digital Flexor Tendonitis (worse in left fore) – in the area adjacent to the distal third of the navicular bone
• Bilateral aseptic pedal Oseitis
The vet has recommended at least 3 months box rest (has already done 5 weeks of this waiting for the MRI) then a further 3 months rest in v.small paddock (couple of stables in size)

The prognosis is guarded. 5-10% chance of sound enough to hack, but may not even be sound enough to be a field ornament (without taking into consideration how he will cope mentally with this and the box rest)

If I don’t try the alternative is pts, and I’m looking at all options to avoid this (while in his best interests)

I have heard and read a lot about Rockley farm, and have sent them an email.

Has anyone else experienced this and had the horse come sound after DDFT damage in the foot? I am completely devastated and will try to do everything for my boy, but I don’t want him to suffer, he is happy in himself at the moment, although going a little stir crazy at the box rest at times. (which is a concern at the back of my mind, but I have to try for as long as he copes mentally)

Sorry I may not have explained this very well, I am so upset (my first horse, only had him 18 months) and still trying to understand it myself.

If you have any thought or advice I would appreciate them (good or bad)

Thank you for reading
 
Wish that I could offer help, but I am afraid that I have no experience of any of this beyond the MRI. One thing that I have done is tried to make sure that I have copies of everything - vet reports, xrays and MRI's, so that I have the information to hand if another potential treatment route comes up. It was useful to have them to hand to show my boys trimmer when she first came up.

I have heard great things of Rockley Farm, so I hope that they are able to offer some help.

In the meantime, I really wish you all the best.
 
Hi

First of all, so sorry, I know from experience how completely devastating - it happened to my horse about 6 years ago.

Your story seems very similar, intermitent lameness and I only had him MRI scanned as I wanted to know exactly was was happening. The tear was as it went into the bone, which I think is a particularly bad place for it to be and the advice was PTS.

Because I could, I decided to retire the horse and he has had a wonderful life - being a companion and friend to anything around the stable yard (he has a very calm easy going nature).

However, I suspect that in the last couple of years he has become sound enough to ride out again - up to then I could see a slight lameness in trot, but that has almost dissapeared now, even on this hard hard ground he is holding up.

I just wanted to say that they diagnosis was probably correct in that they help you make commercial decisions, but if your horse is as much a friend as a horse then there is definitely some hope if you have the patience!
 
There are dozens of sound horses who had ddft lesions and navicular bone abnormalities. I'm not sure how much the "aseptic pedal osteitis" means, pedal osteitis is so often used as a cover all when they can't explain why a horse is lame.

The only alternative is NOT to put him to sleep, and I sometimes despair that vets are still giving that advice. Try him barefoot first. Another bonus is that barefoot rehabs do NOT need boxrest. In fact it is counter-productive.
 
My mare had a tear to her DDFT within her hoof which like you was found by having an MRI scan. I had similar treatment to you with the remedial shoeing, box rest, hand walking etc. She did come sound and hers was a bad tear so have hope, its just very upsetting at the time. She also had her navicular bursa medicated as there was inflammation there and so far all is good. There are other options open to you as others say in the barefoot rehab to try. You will just have to see which way you want to go and of course take into account your Insurance company/claim. Rest seems to be one of the key factors and speaking from my personal experience, the vets were absolutely right with my mare and my Farrier, who is superb, worked with them and the end result speaks for itself.

All I would say is dont rush the recovery, hard it is but well worth it. PM me if you want any more info and good luck x
 
Rest, rest and more rest, with a heap load of patience thrown in. It's the hardest thing at the time, but it really paid off with my mare. She tore a 2cm hole in her DDFT below the navicular bone four years ago. I'd only had her eight months, she was my perfect confidence-giving first "proper" horse, she was going to teach me to have fun and I broke her :(

She was 9/10 lame on the first day, and half a tenth lame after that. It took the vet three months to agree to reccommend an MRI so the insurance would pay (half). Nothing else showed anything (had full lameness workups, twice) as she was lame on right fore too from compensating, and it was so far down in her foot they couldn't do much to get at it (ultrasound would have showed tear but couldn't see into hoof cavity).

She was eventually diagnosed with the DDFT tear, bad degeneration of the cartilage at the end of the tendon, and sidebone (nothing to do with it really, vet just threw it in there!) X-rays had already shown that despite her looking very upright in her outward conformation, her hoof-pastern axis inside was actually broken-back, probably causing the extra strain on her DDFT. She was given a 25% chance of return to "full work" as an RC horse, vet told me I should shoot her (pretty literally). Told him where to stick his gun and got another vet, who got her on a course of Cartrophen and told me to expect not to ride her again, and definitely never school or jump her again, but she was willing to give her a shot.

She was shod very carefully for five and a half months whilst she was on box rest, which progressed to turnout in a gradually larger pen (she's a big girl, and whilst is pretty much horizontal normally, box rest sent her loopy and she was quite scary to handle sometimes so we pushed to get her turned away ASAP). She then had 18 months off - I had researched quite a lot (was a student so had access to all the journals) and found that time period seemed to be the generally accepted amount of time that it takes a tendon to heal.

She then started very, very slow walking, literally five minutes a day for two weeks. She was still marginally lame by this point. We built it up over two months, then started sitting on her. Still lame, so we got her shod in front which improved things. She walked under saddle for four months, then shod her behind and started very tiny trots and bingo, she was almost sound :)

Anyway, I'm already rambling so I'll cut it short and say that she had a summer of light hacking in walk and trot, had the winter off, came very slowly back into work the following spring and by the end of the summer was sound enough to do a few small canters. Another winter off, and this year she is feeling MUCH better than ever before :) She doesn't stumble on rutty or stony ground like it hurts any more, she doesn't struggle round corners (she was worst on a left-hand uphill corner) and is offering canter on the left lead which she has NEVER done with me before. Rest, time and patience are the best healers IMO.

I read that "old horsemen" used to cut a horse's tail off below the dock if it injured a tendon, and stuck it in a field. It wouldn't be touched until its tail was on the ground! Gives a good guideline ;)

It's not the end of the world. Things can be managed, and it will always look worse in the first year. Best thing you can do is turn horsey away for a bit, I think.
 
Thank you all for your replies and kind thoughts. Its nice to hear a few positive stories. Perhaps there is some hope - Its just such a lot to take in.

I will try anything to get him right, he is much loved and even if I can only get him field sound that is better than the alternative. However, I worry because while he is not the most highly strung he can be a handful, and a bit of a worrier at times. So far he seems to be OK on the box rest I'm not sure how long this will last, equally he loves to have a job to do, and thrived on work and going to shows, I just hope he will settle to field rest as whatever happens mentally he has to be happy as well.

I asked the vet if I could turn away for a year and was told not with the tendon damage - the only way this will heal is resticted movement i.e box rest and if I risk turning out it will make it worse and then that would lead to pts. - This scared me so am going with box rest for now.

I am very interested in the barefoot route I want to find out more about it as I think this is where I am heading.
 
Pedal osteitis can be seeno n x-rays so not a get out...
care re: barefoot-anyone can say something and sound like they know what they are talking about if they can talk loudly enough. Your horse is injured and experienced professionals have given you their opinion. Discuss everything with your vets before making management changes (in saying that, I see no reason you would have him shod on box rest anyway)
Can't offer you any other advice, best of luck, not much fun
 
Susie T - Thats interesting when he was X rayed the vets didn't really find anything particular - other than the broken back hoof pastern angle.

The vets and farrier want to continue with wedges and bar shoes to help with his angles to releive the strain on all the tissues etc.

The way the vet explained pedal osteitis was that it was trauma to the bone caused by long term strain/damage because of the poor confirmation of his feet.
 
nic83 said:
I asked the vet if I could turn away for a year and was told not with the tendon damage - the only way this will heal is resticted movement i.e box rest and if I risk turning out it will make it worse and then that would lead to pts.
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I wouldn't have said it's the turnout that causes the issue, surely - more like the turning out? Mine jumped out of her stable-sized pen (six foot electric fence, untouched) and buggered off down the field, but as soon as she had settled in a large enough field she was much more chilled and less likely to do damage in the field than in the stable - she developed a box-walking habit whilst on box rest, and always went left despite her being more lame on the left turn :rolleyes:

I think that's why vets reccommend walk work before turnout, to ensure they don't run round like idiots in the field. I dosed mine up on Sedalin instead ;) She was, and still is, incredibly laid-back though.

As someone else has said, only your vet knows your horse and situation so run anything past them first and take their advice very seriously - but maybe suggest that once you have settled yours in the field, eventually, that he gets turned away for a year?
 
I will of course take the vets advice - I have found her very helpful, and when I suggested barefoot she said she would look into it as well as it might be worth a go.

Dillon is a bit of a loon in the field (has jumped put over gates and post and rail fencing earlier this winter) how I will keep him in a small paddock I have no idea. You are right its the turning out each morning which is the problem.

Hopefully after the box rest and some small paddock rest (with sedalin) he can be turned out 24/7 as this may chill him out as it will be less exciting if he is out all the time. I guess time will tell and I can make these decisions when I get to that point.
 
Just to add as well, if your vet recommends one thing and you do another then you may run the risk of your Insurance co not paying out. Be careful there. My mare had the wedges in her shoes for the same reasons as your horse, to relieve the pressure on the tendon. If you are researching the subject you will also see that the blood supply to the lower leg is in a word crap, and this is one of the reasons it takes so long to heal. I used magnetic boots (Premier Equine) to help increase blood flow. Whether they work or not who knows but she came sound and hers was a bad tear, PTS was also mentioned to me too. We too did lots of walk work on the roads and eventually trot work uphill only and collected in short spurts. We have gone on to do Walk Trot Dressage last year and Im happy to say we did quite well. The proof is in the pudding and unfortunately if you put the time and effort in you will get the results you want eventually. It helped me that I rode other horses for people on the yard so kept up with my riding and it wasnt so bad my own horse was out of work. One of these horses was recovering from a check ligament injury so that was interesting and rewarding seeing him come sound.
 
How did they diagnose the pedal osteitis then? Re: the wedges, that is the only thing that would concern me as wedges are a bit of a misnomer, can cause more trouble than they're worth andwould ideally not use long term,. Assume if it has MRI these are experienced referral vets?
 
nic83 said:
I will of course take the vets advice - I have found her very helpful, and when I suggested barefoot she said she would look into it as well as it might be worth a go.

Dillon is a bit of a loon in the field (has jumped put over gates and post and rail fencing earlier this winter) how I will keep him in a small paddock I have no idea. You are right its the turning out each morning which is the problem.

Hopefully after the box rest and some small paddock rest (with sedalin) he can be turned out 24/7 as this may chill him out as it will be less exciting if he is out all the time. I guess time will tell and I can make these decisions when I get to that point.
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My mare always came in on a night traditionally. She was turned out in May last year and she stayed out, first time ever. Pretty much on a bald field so her weight stayed stable, shes a good doer. By staying out 24/7 we didnt have the running around the field first thing madness. Best thing I ever did and dont forget if you turn Dillon out sometime soon there is grass now whereas when you had him out in winter, presumably where you are there wasnt.
 
i would take the shoes off, trim, and turn out and leave out to heal as mother nature intended (on the move). give him a year in the field and then pick him up slowly, 6 to 8 weeks pavement pounding in walk then another 6 weeks in w/t. keep his feet trimmed every 6 weeks. obv still worm/teeth/brush his hair. reduce feed to forage only. rug according to type and weather.
 
nic83 said:
I asked the vet if I could turn away for a year and was told not with the tendon damage - the only way this will heal is resticted movement i.e box rest and if I risk turning out it will make it worse and then that would lead to pts. - This scared me so am going with box rest for now.

I am very interested in the barefoot route I want to find out more about it as I think this is where I am heading.
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Please ask your vet to talk to Nic Barker of Rockley Farm. She will happily share her knowledge with your vet. She is on approaching 30 caudal hoof lameness (back half of the foot) barefoot rehabs now and around 80% of them are in full work with no medication after finishing a rehab. The vast majorityof those had already been through remedial shoeing and medication and were still lame. Many of them were recommended to be either retired or put to sleep.

It is not true of tendon damage within the foot that the horse needs rest. The injury needs rest, not the horse.

IF the injury was caused by a toe first landing, then getting the horse landing heel first will allow the injury to heal with the horse kept in work (to whatever level it is capable at the time). Check your mare by walking her on a hard flat surface and videoing her and watching it in slowmo. If she is toe first landing then you will have an answer to why she got this injury, and a good pointer to the likelihood of her coming sound if you can change her gait to heel first.

Rockley routinely rehab DDFT injuries without resting the horses and never, ever, box rest them. And yet they have a much higher (about 4 times) success rate with returning these horses to full work in spite of the fact that they have already been treated with medication and remedial shoes and failed to come sound. Clearly, box rest is not required to resolve DDFT injuries inside the foot, or they could not acheive those results.
 
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Susie T -Re pedal osteitis - It was on the MRI report, my vets dont have MRI facilities so he was referred to Bell Equine (I'm in Kent) for the MRI and thats what the report said - it didn't really say much more about it the focus was on the DDFT and navicular

Izzwizz - thaks for the tip re magentic boots, I'll look into it. Field he jumped out of wasn't great in way of grass, but he did then go out in another which had been rested all winter and he jumped out of that too - proper fencing too. - He wasn't being worked as it was winter and no arena so I think boredom played a part - He is a bit of a character, but he is very precious and I wouldn't change him, its who he is.

I have lots of food for thought and further discussions to have with vets, farrier, barefoot trimmer etc. I will no doubt be back here with more questions - but thank you everyone for your advice and comments, I feel more positive that there are options and while it may be long, there is a road to go down and its not the end.
 
CPTrayes - I have emailed Nic today, and my vet is also looking into it incase she can do a referral and I can get some of it on insurance (worth a try)

I have watched some of the videos on the websites and looked at this with my horse and although I haven't watched slow motion (no idea how) I think he lands toe first.

Hopefully I will hear from Nic soon and I can pursue this route. As someone who is not an expert, or experienced with this type of thing it is quite hard and a minefield when you get such conflicting advice, but I can see the logic in barefoot and think this may be the way to go.
 
Nic83 if you do decide to go barefoot it may not even be long. A typical rehab from Rockley goes home at 3-4 months completely sound and in work. Several of the owners have been cross country jumping or hunting when they go to pick them up. My own rehab was 10 weeks to come sound after 2 years lame. My story is not particularly unusual and I am not particularly clever with rehabs and I don't have any special facilities.

Good luck.


I cross posted. I am glad you've contacted Nic. I know she has a waiting list if you were thinking of sending your horse down to her. She is immensely generous with her knowledge, though, and I know she'd love to talk to your vet.

If you have a toe first landing without bone spurs anywhere, just ddft and navicular bone changes, then you have every reason to hope that your horse will be back working in the not too distant future. I do hope so, for both your sakes.

Depending on your insurance company, if your vet refers you should get at least 50% paid for. Lots of people there are insurance cases on vet referral.
 
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Nic83 My horse was one of the rehabs at Rockley, look for Frankie on the blog. He had damage to the DDFT, Collateral Ligaments and DSIL in both feet and didn't respond to 18 months of rest, remedial farriery,cartrophen, slow bringing back into work, in fact at the end of all this he had actually got worse and wasn't even staying field sound never mind in ridden work. Not surprising when you realise the recovery rates for DDFT injuries are 22% and Collateral ligament 11%.

My vet was sceptical but agreed to refer him to Rockley on the basis it couldn't do any harm.

If you have any questions about what they do there and what the experience was like, feel free to get in touch.

This is him a year on.

CHA_0102a.jpg


PS we had an MRI at Bell too as this was before the RVC got their MRI machine.
 
Hiya, a horse I had on loan tore his deep flexor. He had it operated on & some hormone injected in. He spent about 6 months total box rest followed by a period of controlled work, around 2 months, then was allowed out in a paddock. Anyway to cut a long story short he came sound and is able to school & hack, this was 5 years ago and he is still going strong. The best thing our vet did was take his time with it, the vet's who did the MRI said box rest for 2 months then start controlled work etc but my usual vet (who is a lameness specialist) kept him in much longer & we did a really long time of walk in hand etc...and it has paid off.

If you want to PM me I can probably dig out all the details of what we did etc...
 
havent had time to read all posts but thought id comment as my pony has had a tear to the ddft.
She was diagnosed october 22nd and went on box rest for 6 weeks- luckily was the freezing winter so it didnt seem so bad to have her inside with tonnes of hay rugged up and cosy! but she hated being in after a while and when we had to 'walk her in hand' she would buck, rear and gallop off. (on frozen ground..) she had wedge shoes on at the time but these were reduced and she is now barefoot which i believe is a lot of horses saving grace for tendon injuries. In the end i just turned her out- she had a mad half hour of bucking rearing and going nuts, (but no worse than what she did with me on the end of a leadrope! >< ) then calmed down and was happy living out.

She was and always will be fed msm for strong tendons incase she does tweak them at any point- unfortunatly it appears to be reinjury (wonder if this was why she was reduced hmm) that hadnt been given chance to heal up properly- so hopefully with the carefull rehab she will come sound- the vet thinks she will come totally sound and can come back into full work :) she is doing very well so far and we are doing dressage competitions (and failing i might add- she thinks the buzzer = jumping..) hacking for a fair while and schooling- i even put her on the lunge yesterday for 5 mins as i didnt have time to ride and want to exercise the tendon to break down the scar tissue.

Work was very gradually increased , from an extra 5mins walking per week and trot was introduced in a matter of strides per ride, no tight circles allowed etc - can jump in september again. she gallops around the field all the time jumping and leaping in the air and having fun and hasnt gone lame since, dont know if this will continue but can only hope . hope your horse has a good recovery and comes sound. i hope this shines a bit of light at the end of the tunnel-
 
Barefoot, time & controlled excersise is the key I'm sure. My boy was onbox rest for 4 months, by month 3 the box rest & Sedalin where giving us more problems than his foot.

So he was then T/o in a tiny circular pen, I moved it everyday so he got fresh grass & I also put him on V-Kalm (which is a godsend).

He was doing in hand walk work from month 2 & then by month 5 we put him under saddle & started hacking. We've had odd bits of lameness but it seems that the lameness bits may of been adhesions breaking.

He's now T/O in just over 1/2 an acre & is back to being the playful spoilt brat lol, he's stayed sound even galloping on my clay concrete ground so I'm very hopeful he will come back to his old dressage job.

However time really is the key don't rush anything double or treble all walk work.
 
It is lovely to hear all these positive stories.

Have put my vet in touch with Nic at Rockley farm,but her initial thought is its worth a try. I am going to arrange to go and visit, but all being well I think he may go there to see if they can help him. - I will keep you all posted and thank you for your kind thoughts and comments!
 
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