Possible soft tissue foot injury

[Annagain]

You may have noticed that I've been a bit quiet with gushing over how wonderful Wiggy is over recent weeks. You may be grateful for that but unfortunately it's due to him being off work. He's been the tiniest amount lame on his left fore since the end of June, it's just the odd step on the turn on the left rein.

He had two weeks off in the hope it would sort itself. He was fine for a day or two but went lame again. He had a workup and a full course of danilon. We tried him again 5 days after the last danilon and he still wasn't right. I had a lot going on in the rest of my life so he had another two weeks in the field (vet said he would be fine) and went back to the vet yesterday for nerve blocks. The heel didn't block out but the whole foot did so we x-rayed it. He has the tiniest hint of ring bone starting but it's nowhere near the joint so the vet doesn't think that's an issue. Everything else on there is perfect, he said they're amongst the best x-rays he's seen for a 16 year old, especially a heavier type, in a long time. He's really happy with his foot balance too. This is obviously good news but we're no nearer finding and treating the cause.

He's booked in for joint blocks next week but if they don't point to anything, it's looking like a soft tissue injury which could be pretty catastrophic. Vet said we could do an MRI (he's not insured but I self-insure so have money set aside for this) but realistically all that will do is tell us exactly what the issue is, it won't change the treatment. The longer it goes on, the more I think it's something serious. Vet mentioned DDFT as a possibility at which point my blood ran cold, I've just heard so many stories of DDFTs and none of them have been good. He's totally fine in the field cavorting about like a 3 year old so I know he's not in lots of pain but it's enough to potentially stop his ridden career. I'm gutted for him and for me. It took so much blood sweat and tears to find him, his vetting was perfect, his x-rays are almost perfect even now but he's still lame. I don't think I'll ever trust another horse like I trust him, if he has to stop, I think I will too.

I'm trying not to put the cart before the horse but does anyone have any experience of soft tissue injuries in the foot and any advice on giving him the best possible chance of recovery please? Whatever he needs, he will get but I'm terrified it won't be enough.

 

[Zoeypxo]

If i had the money i would MRI personally.

Is he shod or barefoot? How was his hoof balance on the x rays?
Mine injured her ddft 2022 and did recover well for hacking/fun rides but i wouldnt feel comfortable schooling her again as i am too paranoid about re injury. Shes also 16.

 

[Lucky Snowball]

sorry to hear your update. End of June is only about 6 weeks which is not long. Personally I’d give it a longer rest before jumping to any conclusions. Fingers crossed in a few more weeks all will be well.

 

[Alibear]

In your situation, where he is so much the horse for you, I'd have an MRI just so you know what it is. It might not affect the outcome, but you won't be left wondering what if. MRIs can be worth shopping around for, and there can be four-figure price differences if you do both fronts.

 

[alibali]

You asked if anyone had been in a similar situation. My previous horse was around 2/10 to 3/10 lame particularly on circle but also on straight. He blocked to caudal hoof. X-rays perfect. Like you I self insure. Spoke to vet who agreed MRI wouldn't change treatment and diagnosed soft tissue injury in rear of hoof & recommended heart bars/rest/gradual rehab.

Horse had his front shoes off for the x-rays. By chance my farriers wife had a baby same day and was unwell so my farrier was unable to come out for a fortnight. Within 24 hours of having his fronts off I noticed horse was standing better. The improvement continued so when farrier finally came I took a leap of faith and asked him to take the hind shoes off rather than remedially shoe him. I did full a in hand transition walking him on tarmac (which I'd swept clear of stray stones for his comfort as he was very footy) 3 times daily always in the dark as it was mid-winter. Built up the distance gradually then started riding out in walk gradually building up distance. After about another 6 weeks introduced short straight line trots on hacks and gradually built up from there. Horse was sound before I started to ride and never went lame on that leg again. I don't school much and jump even less but horse went on to do a lot of pleasure and some 30km endurance rides. He never got over his footiness and was booted up for every ride but other than that I had no further issues.

There's no way of telling of course if our horses injuries are similar or completely different however I thought you might like to hear a hopeful story which started in a similar way to yours. Fingers crossed you have a similarly happy outcome.

 

[Fieldlife]

Can you share the x-rays and some good side on pictures of his foot balance. I am pretty sure all is good, but nothing to lose.

I have seen vets saying foot balance / digital cushion / heel bulbs and heels are good and not causing a problem, when they are very common looking feet, but not really good biomechanics. Not all vets seem that hot on caudal failure, some seem to accept it as enevitatble in a shod horse.

I really dont mean to say there are people on this forum that know more than your vet. But I think worth sharing the photos for thoughts, hopefully will all look great, but if not it is a relatively achievable improvement can make.

 

[nutjob]

If the lameness blocks to the foot and the xray look fine I'm not sure what info you will get by doing extra nerve blocks. If it was me I would go straight to MRI as it will give you some idea if the horse is likely to need to be retired, or if it is worth trying extended rest and rehab.

 

[PinkvSantaboots]

It's quite common for ddft injuries to be at the back of the pastern and often a scan will pick that up so that may be an option.

My mare damaged hers there she was 14 and I had to retire her as I couldn't keep her sound, vet thinks it was a very old injury ad she had alot of scar tissue, so the only option was steroid but she had cushings and ems so I just retired her.

That was back in 2014 so there might be other things they can do now.

Thats if it is that it may not be I think I would have to mri I would need to know.

I wouldn't call it a day yet his only mildly lame he may just need rest.

 

[HelenBack]

I'm so sorry to hear this. I saw you post on Facebook somewhere that he was off work and was worried that everything wasn't okay.

I'm another who would just go straight for an MRI. We've been three times now and I'm pretty much at the point where if it's not something that's easily diagnosed in one vet visit I just want to go straight to that. You get your answers quickly and last time I probably wasted quite a bit of money in additional vet visits, blocks and x-rays where I could have cut straight to the chase. Also if it is the DDFT then the sooner you know the better really and you can decide whether to go for box rest or turn him out on extended field rest.

If it is the DDFT then hopefully it's not a really serious injury with him only being a bit lame and then he'd have a greater chance of returning to work in time. Ours has ended up as a retirement job but he was much lamer than that and I was told from the outset that it was unlikely he'd be able to return to any form of work. He still mucks about in the field though.

Equally if it blocks more to the foot it could be something like a bone oedema and some time had a bit of steroid might do the trick. For me I would definitely want to know what I was dealing with though, hence why we've had so many!

Give me a shout if you want to talk things through, I know it's a worrying time and can be difficult to decide what to do for the best.

 

[Season’s Bleatings]

My horse had a ddft injury in 2022, diagnosed via MRI. While most of the damage was in the foot, there were a couple of other areas higher up.
In my case, he was a good candidate for surgery so he went to UCD in Dublin. He also had PRP immediately post surgery and laser therapy started a few weeks after.
He box rested quite well, we started hand walking 2 weeks after surgery and slowly slowly built it up until we were doing laps of the yard in walk as of Jan 2023, then he went away to a pro for some hacking in June 2023, home in August and then we only hacked until December when we introduced some small bits of arena work.
Vet was very happy with his progress and we went out to aff dressage in June this year.
Unfortunately the big twit has now tweaked something behind so is on holiday currently, but still doing very well on the dodgy leg.
For context my boy is an 11yo ISH, 17hh monster and his was a field injury.

 

[dreams579]

Look at the rockley farm blogs. http://rockleyfarm.blogspot.com/

No reason at all a ddft injury means automatic retirement!

 

[visa_bot]

Mine had similar symptoms and it was a bone bruise in the foot. Not visible on xray so MRI was the only way to see it. As others have said might be worth going for MRI. Takes a long time to heal, but given field rest it went away and hasn’t come back.

 

[millitiger]

Having been in the same situation in May, I would (and did) MRI.

I think you are near me; we went to B&W vets for standing MRI and it was 'only' £1600 for both front feet.
We are also not insured

I wasn't sure whether to do it or not - same as you, does it change the treatment, what is the point if he needs rest anyway etc.

I'm SO glad I did as his MRI was clear!
He had a teeny bit of inflammation at one point but no pathologies at all. We did 2 weeks with Bute to settle the inflammation, he had 8 weeks in the field and is now moving the best he has for years
I did however take his shoes off and he's now barefoot- this is because his lameness was poor foot balance and tbh, we were really lucky it didn't cause anything more serious.
He is so much happier and sounder without shoes and his feet are improving so much.

Feel free to PM me for more info on him or the MRI

 

[Annagain]

Thanks all for the replies and apologies for the delay in responding. My MiL was rushed to hospital Friday evening and unfortunately died on Sunday so my attention was elsewhere. I suppose the silver lining is these things are happening at the same time so the fact Wig's stuck in the field is irrelevant at the moment.

In response to some of the questions, the point of the joint blocks that the heel didn't block out, just the entire foot so it will help us know whether one of the joints is involved, which we can then medicate. If not, I will probably go down the MRI route. I was thinking I would anyway but your stories have cemented that in my mind so thank you to all who shared their experiences, especially millitiger with the price of an MRI at B&W which is where we would go. That is cheaper than I expected. Stupid question alert, do they have to do both feet or knowing the issue is in the left, could we do that one only and save a bit more?

I don't have copies of the x-rays at the moment but I can get them on Friday when we go back.

I did wonder if barefoot might help him longer term so that's a point of view that's been really useful to read. We don't really do much that would require studs - the odd bit of dressage on grass and an occasional XC lesson but we can probably cope with that.

I understand the point about foot balance and caudal failure but I think the fact that the heel didn't block out suggests that it isn't an issue here? I saw plenty of heel issues with Archie and every time he came sound wth the heel blocks, Wiggy didn't.

 

[nutjob]

do they have to do both feet or knowing the issue is in the left, could we do that one only and save a bit more?

I think they prefer to do 2 incase there is something marginal so they can compare but mine only had one foot done, he had a sdft injury which was obvious. I wasn't insured so was concerned about the cost.

Sorry for your loss you must have a lot to deal with atm.

 

[Season’s Bleatings]

Mine only had MRI on the affected foot as well

 

[millitiger]

@Annagain I had both done, as we weren't sure what the issue was.
Therefore, they did both feet so they had the 'good' foot to compare to as some things are so small or within normal range on the 'bad' foot, you wouldn't know if it was an issue or not without the comparison. I hope that makes sense!!

They said if they know or have a better idea on why you have lameness or it's a stronger lameness, they may only do the affected foot as you'd expect any internal damage to be easier to see.
So a keratoma or if x-rays are only bad on one foot etc.

I think they also said the price only drops to around £1200 for one foot so, to me, the saving wasn't worth it compared to having a full picture of what was going on.

 

[Annagain]

Quick update - joint blocks were inconclusive. He improved when the coffin joint was blocked but it didn't eliminate the lameness completely (I thought he'd come sound but vet said he was still ever so slightly lame). The pastern made no difference. Vet suspects there's something soft tissuey going on in the area of the coffin joint so the joint is sore but so is the soft tissue around it, hence the partial improvement.

He's on box rest (was just in field until Friday) and booked in for an MRI a week Friday. I feel sick.

 

[HelenBack]

So sorry to hear this, hopefully it's something less serious than the DDFT given the location of the soreness.

The only thing I can say is that I think I knowing is better than not knowing. Not much consolation though I know.

 

[HorsesRule2009]

Quick update - joint blocks were inconcusive. He improved when the coffin joint was blocked but it didn't eliminate the lameness completely (I thought he'd come sound but vet said he was still ever so slightly lame). The pastern made no difference. Vet suspects there's something soft tissuey going on in the area of the coffin joint so the joint is sore but so is the soft tissue around it, hence the partial improvement.

He's on box rest (was just in field until Friday) and booked in for an MRI a week Friday. I feel sick.

I was always taught that with nerve/joint blocks you don't expect them to come sound but show an improvement in the lameness?

I hope the MRI can give you some answers

 

[Annagain]

I was always taught that with nerve/joint blocks you don't expect them to come sound but show an improvement in the lameness?

I hope the MRI can give you some answers

Vet said as he'd come completely sound with nerve blocks, you'd expect the same reaction with the joint block if it was the only source of pain.

 

[PinkvSantaboots]

Fingers crossed its nothing too serious it could just be the navicular bursa they respond well to treatment and rest.

 

[deicinmerlyn]

Similar story with my TB when he was 9. Eventually had MRI which showed tiny tears in both front feet in DDFT, left worse than right.
Had various treatments and shoeing which worked for a while then stopped. Eventually the same year I removed his shoes and he gradually improved back to full soundness without any other intervention.
He mostly remained well for another 11 years. He was pts last Christmas although not entirely sure it was because of the old injuries as he wasn’t lame but may have been bilateral. But I felt something was going on and he wasn’t happy or comfortable and started tripping, falling in the arena, so called it a day before he deteriorated further.

 

[Fieldlife]

I was always taught that with nerve/joint blocks you don't expect them to come sound but show an improvement in the lameness?

I thought that was because they will have been compensating for the pain in joints and caused pain in other areas of body. So when block joint, and stop joint pain, are still feeling the soreness from compensating in other areas.

I also think vets differ in how significant an improvement expect on a block before they conclude it is the main source of the pain.

 

[Celtic Fringe]

So sorry to hear about your MIL.
Just to say that my cob was 'not quite right' and vet investigations were inconclusive so he had a MRI at B&W a couple of years ago now. This showed some issues in his coffin joints. He had 4-5 months off work without shoes out in the field and then Arthramid in both coffin joints. He came back into work sound and very keen! He has not needed any further intervention since. He is shod now because the local hacking is incredibly stoney and due to competition demands but if you are able to consider leaving shoes off then I'd go down that route but make sure that you have an excellent farrier/trimmer who can maintain foot balance.

 

[Annagain]

I’ve been toying with barefoot anyway just because I think he’d cope absolutely fine without shoes but we have one particularly stony path that we need to hack over that worries me.

 

[santas_spotty_pony]

So sorry, I’m sure the mri will give you answers. Fingers crossed it’s not DDFT related.

 

[millitiger]

I’ve been toying with barefoot anyway just because I think he’d cope absolutely fine without shoes but we have one particularly stony path that we need to hack over that worries me.

We're hacking in boots very happily.
Also been on fun rides etc.

Even just a break from the shoes for a bit to 'reset' can sometimes be helpful.

Hope your MRI goes well and only shows something minor

 

[rara007]

let us know what the mri says Good luck!

 

[Annagain]

MRI booked for Sept 6th. The only date they had before them was the same day as my MiL's funeral. Sod's law. In the meantime, he's being a total poppet on box rest, bless him. He goes out into a makeshift tiny paddock while I muck out, it used to be a little corridor between two gates but one of the gates has been removed so we just tie a lunge line across the gap. There aren't many horses I'd trust to do that with!