Nerve blocking advantages?

[fairhill]

It's been many years since I've had a lame horse, so I was hoping for a bit of information from the lovely forum folk! I have done a quick search but couldn't find much....

My mare went lame yesterday on her left foreleg (4/5). No real difference in digital pulse, no reaction with hoof testers. Vet has been and she's on box rest and bute for a week, then if no improvements the next step will be looking at her tendons etc and doing some diagnostics. Which is where I've got a bit confused

They recommend taking the horse into the clinic for a full lameness investigation - x rays, scans, nerve blocks, which would probably entail a few days livery there whilst anaesthetics wore off.
Or, they can carry out mobile x rays and scans at the yard.

I'm wondering what nerve blocking will add to the diagnosis, how important it is, and whether I should be going for the full work up straight away, or wait until after X-rays and scans?
the cynical side of me thinks they want the horse in as it makes them more money, but I want to do what's best for my mare... Help!!!

Ps I will be talking to the vet about this, just want some impartial views as well!

 

[fishy]

My mare is going to the vets tomorrow for investigations for lameness and they are going to nerve block her. They told me that if they block an area and they then become sound when trotted up it helps them pinpoint where the lameness is. They can then investigate that area with scans, xrays to see what might be causing the lameness. I think they usually start with the hoof and work their way up. It's something I've never had the misfortune to come across before but my vets have been very helpful and happy to answer questions. Needless to say I'm still terrified and hate the thought of leaving her. Hope your horse recovers well on the box rest and bute and you don't need further investigations.

 

[be positive]

Nerve blocking needs to be done first to find where to xray or scan otherwise they will potentially be starting in the dark and could get to where the problem is after a load of wasted tests. I took one in for tests last year we guessed it was foot and that is the most sensible place to start, he blocked out then had xrays which took just a few hours to do, I brought him home then went back the next day to block another part of his foot just to make sure nothing else was going on, I was offered the option of him staying but wanted to be there so took him in myself, I think they can try and stretch things out, especially if insurance is available, the chances are if your horse has no obvious injury that it is just bruising somewhere that will resolve after a few days rest, if not I would definitely start with nerve blocks before anything else is done, unless something flares up to show where the issue is so they know where to scan or xray.
They can usually do nerve blocks at home, as long as you have a decent trot up place, scans and xrays are also possible especially if the cause of lameness is obvious so they are not with you for hours going through the whole limb, it also helps if they are very lame as they will be more obviously sound when the block is in the correct place.

 

[ihatework]

Firstly don't panic yet!!

4/5 is actually really very lame. In many cases of this level of lameness it is just a foot abcess, which is easily and cheaply solved in general. If its not that then if it was something quite serious I would expect to see an obvious area of the limb (heat/swelling/pain reaction). If neither of the above then my money would be on a pulled muscle, for which box rest and bute should see a significant improvement.

So in short, if the horse is relatively comfortable I would say don't immediately jump into full lameness work ups. However if, in time, this is deemed necessary then if you have the option to send into the hospital I would do this - in the long run it often works out quicker/cheaper if the vet really doesn't have a clue where the lameness originates from. You may even be able to just leave the horse there for a day and collect in the evening. It will only be if they want to bone scan or something that a few days might be needed.

Nerve blocks will be needed for a tricky lameness. These will be done first to try and isolate the area of pain, and they generally save expensive, extensive scanning of the entire limb.

 

[sheep]

I would say you are probably better to send the horse off to have the workup done. Mine had a lameness workup in October and the vet explained ultimately it would be more cost effective to leave him there, he could do nerve blocks and let them wear off as appropriate. If you do it at your yard, you may end up with multiple call out charges. My horse was dropped off on the Wednesday evening, workup was carried out throughout the Thursday morning and afternoon, he was ready to come home on Thursday evening.

 

[Copperpot]

Mine went today for nerve blocks. Dropped him off at 1pm and can collect him tomorrow afternoon. Saves more call out charges and when I collect him his hocks will have been injected and job done.

 

[shergar]

A vet could not tell where our pony was lame,a friend took five minutes with a thermal imaging camera and pin pointed the problem,saves messing about ,once you can see where the problem is have the vet x ray or scan at your yard.
We had a horses leg clipped and scanned at the yard a few weeks ago cost for that was £130.
If you Google thermal imaging and find some one near to you wont cost much just for legs.

 

[TGM]

Once all the obvious lameness causes have been ruled out (ie abscess, wound, laminitis etc) then I've always found it usually works out cheaper and more effective to take horse into a respected equine clinic to have a work up, than have the local vet come out several times doing various tests piecemeal. Nerve blocks are a very important part of the process when it is not obvious exactly where the lameness. They usually start by blocking the foot and working up. After every block the horse will be reevaluated and if the lameness improves or disappears after a certain part of the foot/leg is blocked, then that will be the suspected seat of lameness and will be scanned/xrayed.

 

[twiggy2]

i have worked with horses for over 25yrs and have never had to have a horse stay in for nerve blocking, they are either done at home or the horse is booked in for a lameness work up and it is done on the day and the horse comes homes same day. I have dealt with 8 vets in the last year and have been with 5 horses having lameness work ups and it has been the same for all of them in the last year so I do believe it is for the vets convenience and pushes up the cost for insurance claims.
personally i would say no to my horse staying overnight for something that takes roughly 1-2hrs depending how difficult things are to pinpoint

 

[twiggy2]

the foot has to be blocked first, where they insert the needle blocks everything below it, nerve blocking can be a really important part of diagnosis OP

how long has the horse been lame for though? I am another that if the horse has not been lame for long I would be discussing with the vet if they felt there was any great risk in treating conservatively for a week, sometimes it is not appropriate though and we cannot see or feel what is going on with your horses leg via HHO so your vet is the best one to advise you

 

[fairhill]

Thanks all, very interesting reading everyone's thoughts and experiences.

I'm hoping for the best e.g. she's just jarred her leg stamping at flies, and the box rest and bute for a week will sort her out, but planning for the worst if it is the start of tendon troubles.

She looked a bit happier on it today, now the bute has kicked in, so fingers crossed it's not her tendon.

 

[ester]

The reason for possible multiple days of nerve blocking is that usually the initial nerve blocks are quite broad - back of foot/whole foot/fetlock/knee etc. and then you need to allow that to dissipate if you want to block more specifically (say coffin joint) and if you want to then treat by injection.

 

[Copperpot]

The reason for possible multiple days of nerve blocking is that usually the initial nerve blocks are quite broad - back of foot/whole foot/fetlock/knee etc. and then you need to allow that to dissipate if you want to block more specifically (say coffin joint) and if you want to then treat by injection.

This. He was there 24 hours and has come back with both hocks and coffin joints medicated after nerve blocks and x rays. I don't think that's unreasonable of the vets.