MRI Results - What To Do Next

[sasquatch]

Have just had B's MRI results through I don't understand what they mean but from my perspective they don't look good.

I haven't rung my vet yet as the report has only just been emailed to us both, so will most likely ring later today if they don't phone either me or mum. Just looking for some advice on what to do next/what this means for him.

Results have found bone remodelling at the insertion of the lateral collateral ligament of the coffin joint and coffin joint peri-articular remodelling in his LF. I have googled, but am not sure if this means possible navicular or not.

I'm not having the best day already and as I'm now at uni and 2 hours away from poor B I feel even worse and just want to jump in my car and drive straight down to see him

 

[FestiveFuzz]

In your shoes I'd just call your vet before getting in too much of a panic. They will be best placed to explain the results and next steps, google is very rarely your friend in this situation.

Fingers crossed for you x

 

[Pinkvboots]

I would speak to the vet it's normally common practice for them to go through any findings with you afterwards anyway, I would give them a ring and get your vet to call you quite often to non vet people those reports don't make much sense.

 

[sasquatch]

Vet rang me earlier - I still have absolutely no idea what it all means but I do know there is a small bit of hope as vet has recommended treatment and explained if treatment doesn't work we may be looking at surgery.

I've asked mum to ring as signal where I am is very patchy and I don't want to be walking around campus on the phone to my vet (understandably), so didn't get to ask many questions.

It does cause a headache as I am 2 hours away, and whilst I have 3 day weekends this semester, it's still going to be awkward especially if he does come right and can be brought back into work, but I'll work with that when it comes.

As much as people will say it's all a bit of made up superstition, mum has a set of tarot cards and did my tarot surrounding B - weirdly the tarot was right in that it's a result that will cost a lot of money and not necessarily the result we wanted, but also there is some hope in there. Coincidence or not, it is nice to have at least that to hold on too, I think it's even more stressful when you're away and need to try and sort things out as it's not as simple as being to rearrange things as for me to come up and see him I really need if not a whole day, at least most of a whole day.

 

[Pinkvboots]

What is the treatment can you remember?

 

[ester]

So I think...

so peri-articular means around but not involving the joint so like low ringbone in laymans terms I suspect.
remodelling at collateral ligaments would usually be sidebone but if there isn't much remodelling it possibly wouldn't be called that yet.

 

[brightmount]

I wouldn't panic. MRI scans always pick up stuff that sounds scary. My horse had one 12 years ago that picked up what you're describing plus swollen collateral ligaments and a partial tear to the DDFT. We took her barefoot, it was a new idea back then. I used a DAEP. It was about getting the foot balance right and providing stimulation to the hoof in its natural flexible state that promotes healing and slows further arthritic changes. Definitely worth considering if you're looking at your options. My horse is still with us aged 21 and she was about to be PTS aged 9.

 

[sasquatch]

Had the chance to ring mum, vet has explained similar to her as he did to me before I got cut off and wasn't able to ring back due to the signal here.

There is hope - mum was able to expand a little bit more for me about proposed treatment. It would be to inject with steroids again and then to treat with shockwave therapy (?) once every 2 weeks over 6 weeks and we would know within 2 months if he'd come right or not. I think part of this would also include some very careful and precise shoeing too to try and keep him sound. If this doesn't work, the next stage would either be retirement or surgery to cut the nerve.

B is currently barefoot, and I know a lot of people will tell me to keep the shoes off him but when it comes down to it, if shoeing helps keep him sound then it's worth it imo. I know vet actually thought he looked lamer barefoot even with good feet and having been barefoot for months. Also means maybe having to change farriers as mine has been very bad with replying to texts lately regarding getting him trimmed - he used to be really good with replies etc. but I now struggle to get one to the point it took a week to get a reply asking did he know when B was last done and I haven't had any reply after asking him could he trim him next time he's out. It's a shame as my farrier is very good with his feet otherwise and has known B for years but I can't risk non-replies and a farrier who takes over a week to reply setting back any treatment as a result.

 

[googol]

Cutting the nerve is an extremely harsh course of action. I’m surprised the vet even suggested it tbh (because, in the nicest possible way, B sounds like a leisure horse?) if I was you I would think very carefully about it and get at least one more professional opinion.

I think it’s harsh slating your farrier because he didn’t reply quickly enough to let you know when your horse was last shod, he probably expects you to keep a record

Overall, like you say, at the minute it’s a positive enough outcome with some treatment options. I’m keeping everything crossed that you get him right x

 

[PoppyAnderson]

The worse thing you will do is listen to your vet and shoe this horse. You don't need injections and shockwave and remedial shoeing. Are you familiar with Rockley Farm? Read up on them and look at their blogs if not. You would be far better off sending your horse here and getting him properly comfortable barefoot.

 

[PoppyAnderson]

You also need a recommended barefoot trimmer, not a farrier, to support you.

 

[sasquatch]

Cutting the nerve is an extremely harsh course of action. I’m surprised the vet even suggested it tbh (because, in the nicest possible way, B sounds like a leisure horse?) if I was you I would think very carefully about it and get at least one more professional opinion.

I think it’s harsh slating your farrier because he didn’t reply quickly enough to let you know when your horse was last shod, he probably expects you to keep a record

Overall, like you say, at the minute it’s a positive enough outcome with some treatment options. I’m keeping everything crossed that you get him right x

I think cutting the nerve was more suggested as an option to consider if nothing else works rather than proposed course of action - B has already been injected once that didn't appear to work and has also had 6 months out in a field (and has been out of work for nearly a year) and vet saw no change in his lameness at last lameness examination just before Christmas (this was also before the MRI). I don't see surgery as an option atm, he's 17 so not a young horse and can't see being able to afford it.

I usually have a rough idea of when B needs done but with being away and mum saying she would organise farrier etc. I really wasn't sure as his feet looked pretty good. I know farriers are busy people, but I'm more concerned as vet has said that he will need very accurate shoeing that'll have to be kept on top of and if I'm struggling to communicate with my farrier it does concern me a little bit. I still haven't had a reply from him over whether he'll be able to check B's feet next time he's at the yard. I really don't want to change as he has always done B's feet very very well but I know a few others have had problems getting hold of him so if it's going to be an issue may have to consider changing

Thank you, got lots to think about atm but I think I'll 100% be trying the injections and shockwave therapy route. We may as well do our best to meet the insurance cap before we're never able to claim again at least!

The worse thing you will do is listen to your vet and shoe this horse. You don't need injections and shockwave and remedial shoeing. Are you familiar with Rockley Farm? Read up on them and look at their blogs if not. You would be far better off sending your horse here and getting him properly comfortable barefoot.

I'm in Ireland, so Rockley wouldn't be an option. He has had a lot of time off already, and he's comfortable barefoot over a variety of different surfaces. I've had a barefoot trimmer to see him before who said his feet were perfect and there wasn't anything he could see to correct (and whilst he does need trimmed again, his feet haven't lost a lot of shape). I will be following my vets advice, as my vet has seen the horse with shoes and without shoes at various points over the last year and if it the proposed treatment doesn't work I can always try barefoot again.

 

[ester]

If your are shoeing your farrier needs to discuss things with your vet in order to do so in a way that will help optimally.
Has he been on any bute? and would you consider him field sound at the moment?

 

[sasquatch]

If your are shoeing your farrier needs to discuss things with your vet in order to do so in a way that will help optimally.
Has he been on any bute? and would you consider him field sound at the moment?

He's definitely field sound, he's in atm due to the weather so gets limited daily turnout (not ideal, but not much I can do about it and he does get at least a good few hours out each day) but loves to show off his lovely floaty trot and perform his gymnastics when he's out playing with his pals and looks 100%.

He hasn't been on bute or had any pain medication for this issue other than the steroid injection last May, he's 2/5 lame on a circle (if I remember rightly) but looks sound on a straight line and as he's comfortable on all 4 legs at least in walk it was never suggested to try it.

 

[Leo Walker]

Could he not just be retired then? If hes had one injection and it didnt work, it doesnt look good that more will work. The thought of denerving a 17yr old leisure horse is terrifying! They do need more care as well, and its not always a permanent cure. Especially as you are away at uni and will be for some time so wont be able to do any rehab work with him easily. You could find him a really nice retirement yard where he could be out 24/7

 

[sasquatch]

Could he not just be retired then? If hes had one injection and it didnt work, it doesnt look good that more will work. The thought of denerving a 17yr old leisure horse is terrifying! They do need more care as well, and its not always a permanent cure. Especially as you are away at uni and will be for some time so wont be able to do any rehab work with him easily. You could find him a really nice retirement yard where he could be out 24/7

I'm going to try the injection and shockwave treatment and give him one last chance, we are about 1K off the insurance claim cap and won't be able to claim for his feet when the insurance is renewed so may as well try it while we're still covered and if it doesn't work retire him. Vet did say he knows it's been tried once and didn't work, but that he'd like to try it again with the shockwave therapy.

If that doesn't work, he'll be retired. If it does work, he'll need the injections every few months but imo, he is otherwise a very healthy horse and mentally hasn't started to slow down or get a bit more sensible (unfortunately) so there is no harm in trying again.

I know I wouldn't put him through denerving so don't see it as an option for him, but can understand why vet has said if injections and shockwave don't work it is an option if I want a sound, rideable horse.

 

[Leo Walker]

Insurance is so helpful, but such a pain with the timescales! Is he sound enough that hacking only would be an option?

 

[sasquatch]

Insurance is so helpful, but such a pain with the timescales! Is he sound enough that hacking only would be an option?

He probably would be but he's more of a hold on tight hacker than a happy hacker! He's an odd little thing in that hacking across fields he can get very anxious and then winds himself up but on the roads he's generally pretty spook-proof and much more settled.

I'm hoping insurance will pay out if treatment is still ongoing and we haven't reached the claim cap at the time of renewal but will also need to check my policy. I've never had to get the vet out to him for anything but his jabs until now, he really did make sure to go all out!

 

[ester]

If you denerved him realistically he probably wouldn't be rideable, riding horses with a dead hoof isn't always the best plan though some people do.

Did the steroid work at all last time? If it didn't is the vet considering any of the other 'boney' type options like cartrophen/arthramid etc?

 

[sasquatch]

If you denerved him realistically he probably wouldn't be rideable, riding horses with a dead hoof isn't always the best plan though some people do.

Did the steroid work at all last time? If it didn't is the vet considering any of the other 'boney' type options like cartrophen/arthramid etc?

I'm not 100% sure if it'll be the same steroid injection or a different one. It could well be that now vet knows the problem he wants to try a different option to inject along with the shockwave therapy.

The steroid worked for about 2/3 weeks, it took about 4-5 days to start to work and then B spent a week bouncing. He was sound enough I was able to get a 45 minute lesson in w/t and instructor said he looked very nearly 100% but when turning left very tightly looked slightly off if I didn't balance him, but looked alright if I did balance him properly and he was fine on circles. I introduced canter about 3 weeks after he was injected as he seemed to look and feel sound (a few strides on a straight line) and the next day noticed in trot he felt a bit off but on the ground people said he looked okay, so friend got on and rode him and she said she felt it too and he hasn't been sat on since.

I'm not considering denerving him atm but still want to ask about it and find out a bit more, there's no harm in asking anyway!

 

[liz26]

You should consult your vet at first and then follow the steps as you already have the MRI results.

 

[PoppyAnderson]

Why are you ruling out a proper barefoot approach? The vet recommended treatment will not work but you clearly want to only pursue this route. At best, you will get a very short term superficial 'improvement' but it's not sustainable because it's not addressing the heart of the matter. If (when) it doesn't work, you'll then retire? Bizarre. Taking the barefoot option will A. work B. cost a whole heap less money and C. be far less traumatic for your horse and yet you're simply ruling it out?

 

[Rowreach]

Why are you ruling out a proper barefoot approach? The vet recommended treatment will not work but you clearly want to only pursue this route. At best, you will get a very short term superficial 'improvement' but it's not sustainable because it's not addressing the heart of the matter. If (when) it doesn't work, you'll then retire? Bizarre. Taking the barefoot option will A. work B. cost a whole heap less money and C. be far less traumatic for your horse and yet you're simply ruling it out?

How can you possibly know what will or will not work for this horse?

 

[ester]

and how does the OP manage to said rehab when she is miles away from the horse? I think we discussed this previously but even the summer holidays weren’t really longer enough.

 

[SusieT]

PoppyAnderson I think you need to wind your neck in. The vet has seen this horse and prescribed treatment - you are entirely out of bounds telling someone that a recognised treatment is wrong, wont work and will be more effort and offering something that is a bit alternative and 'wacky' in conventional terms.
You have not seen this horses mri scans and cannot say anything specific will work.

 

[sasquatch]

Why are you ruling out a proper barefoot approach? The vet recommended treatment will not work but you clearly want to only pursue this route. At best, you will get a very short term superficial 'improvement' but it's not sustainable because it's not addressing the heart of the matter. If (when) it doesn't work, you'll then retire? Bizarre. Taking the barefoot option will A. work B. cost a whole heap less money and C. be far less traumatic for your horse and yet you're simply ruling it out?

The horse has been barefoot in a field for nearly 7 months with very strong healthy feet and he is no sounder. Barefoot trimmer saw him over summer, told me his feet were perfect and I should be riding him again within 2/3 weeks(!!). He hasn't been sat on since the start of June, hasn't done more than 30 minutes (max) walk/trot since April 2017. He is able to walk over pretty much any surface barefoot, his feet are rock hard and he stomps everywhere. I don't see how 12 weeks of barefoot treatment will suddenly make him sound if the vet saw no improvement in him after 6 months barefoot with very good feet. If barefoot was going to work for this issue, I would expect to see at least some improvement in that time period - much rather take that very short-term superficial 'improvement' and get some improvement and another few years with him (as if it works, thats what we're looking at), as that short-term improvement will be more of an improvement than being barefoot has been for him.

Thank you Rowreach, ester and SusieT. 12 week rehab would indeed be nearly impossible for me to do from 2 hours away, whilst the proposed treatment whilst awkward is workable as I have fridays off so can come home on a thursday and arrange all appointments for friday. B has his first session on the 9th so fingers crossed!