Pastern Joints

[Jomanser]

This is a long one sor sorry in advance!

In October last year I noticed my boy was slightly lame on the right rein. Called vet who first of all advised weeks box rest. This I did, they came back and lameness no better, so had to go to clinic for lameness workup. Diagnosed as degenerative joint disease of right fore pastern joint. This was treated with steroid into joint and 6 weeks box rest, followed by walking in hand and slowly building up to full blown 40 mins exercise. All throughout this he was sound.

Mid Feb he started to show signs of being unlevel again, so called vet back and they said they wanted to re-do the treatment. This they did and within 6 hours he was hopping lame - I mean fracture lame - couldnt walk in from field. Eventually got him in and we suspected the boney growth may have been chipped off and floating in the joint. However within 12 hours he was putting weight on it and within 2 days was back sound.

ANyway, have just started riding again in the last 2 weeks and then last night he looked unlevel again. Not bad, but enough for me to notice. Spoke with vet and they now want to send him for an MRI scan or Athroscopy. I am really hesitant to send for Athroscopy as I dont want him under GA. He is a big boy and 19years old and I think it's too risky. They also dont know yet if you can perform an Athroscopy on a pastern as it is so small!
Only other option is an MRI. My issue is that I have a max budget of £1000 diagnostic budget on my insurance and an MRI will be a lot more than this I think. Also if the MRI shows up that it's a ligament or tendon problem, I wont be covered at all as this is excluded from his policy!
Dont know what to do for the best. If I had the money I wouldnt hesitate with the MRI, but I really cant afford to pay for it. Anyone else had this treatment done? Or can offer any advice? x

 

[Marchtime]

Sounds a little familiar. My boy was diagnosed with degenerative joint disease affecting both coffin joints (worrying considering he was 8yrs old). X-rays supported this diagnosis. Same treatment as your boy and came sound for nine months. Then suddenly very lame. Vet back out and we sent for MRI. No degenerative joint disease but instead chronic wear on medial collateral ligaments. There is no way to diagnose this without MRI. Sadly also there is very little treatment except turning away for anywhere up to two years. My boy is now returning to work.
If you can't afford an MRI then you don't have many options. If he is older would it be feasible to retire him? Performing an athroscopy with a definite diagnosis seems a huge risk to take. I know my vet is doing some research using my horse to see whether collateral ligament damage could be diagnosed using ultrasound scanner. Results are uncertain - you can see some swelling in my boys ligament but apparently it's not overly successful but maybe worth talking to your vet about?
The other thing is try explaining to your vets about the money issue. I know our vets have two price lists - one for insurance and one for non-insurance, maybe there is some way to get it cheaper?

 

[Jomanser]

Thanks Suzie_D. Problem is he would have to be referred to Newbury so I would imagine it's one price for all. If he was diagnosed with what your horsey had then I would be stuffed as it would be excluded from the policy.
Also they could then turn round to me and say 'well if it wasnt his pastern joint after all then you have to re-pay the £1700 we have paid your vets'...

Oh god, what a nightmare.

I have toyed with the idea of retiring him from competition. He is sound enough to be a happy hacker. I have to keep reminding myself he is 19 and not the 5 year old I bought.

 

[Marchtime]

No they definitely won't make you repay the money, or I can't see how they could.
On the slightly up side if by any chance he did have collateral ligament damage treatment is pretty much free - lots of rest and taking it easy! Maybe give him a breather for a few months and take it easy. It's a hard choice to make but I've decided to keep my boy as a happy hacker only now as every time I try to push him to do dressage he breaks again. Hacking is far better than nothing.

 

[Charlie77]

My boy was diagnosed with arthritis of the Coffin Joint last May. (He's only 13) He had never shown any signs before we went for a hack only walk n trot he did a huge spook on the way home, came home turned him out looked at him 30 mins later & he was hopping lame, he had a week on box rest a week turned out then went in to the vets to be diagnosed! on the day he was only 1/10th lame, he had 3 HA injections, cutting a long story short he's been mostly sound ever since, his big problem is hard & un level ground, or when his has a prat attack in the field! he's fine in straight lines but cant do circles ect, back last autumn he had had such a day & a hour later he couldn't put his foot to the floor! next day he was fine.

The best thing for my boy is to ride him enough so that he's not board and getting him self in to trouble, but not to much either! though last week he jumped up a 5ft bank and came home sound! (Not intentional might I add) he's on a good joint supplement but not on any Bute ect yet, ( apart from on the odd bad day) Its hard to think he wont BSJA again, but he's happy in him self.