Potential Arthritis - what should I do?

[Tiddlypom]

Did you get any sort of discount on your premium to keep the policy running with all those conditions excluded?

 

[Ellietotz]

Did you get any sort of discount on your premium to keep the policy running with all those conditions excluded?

Actually, funnily enough, they put it up!

 

[njc]

Actually, funnily enough, they put it up!

Hopefully they’ll cover the knees if not I agree with cancelling you could always look into one of the catastrophe cover policies going forward. Also agree knees may be just sore from the fall. I’d worry about saddle fit and to shoe or not after you’ve decided what to do with the knees

 

[Ellietotz]

No heat in the knees today.

I did have a thought though, when the physio was out 7 weeks a go, she did make me hold up her front legs for a good 20 minutes each side to stop her kicking out in case she did. She hated this, kept yanking her legs out of my grip, rearing up and landing heavy in protest. I wonder if this had something to do with it...

 

[Tiddlypom]

Actually, funnily enough, they put it up!

They are taking the pee!

Your physio made you hold each front leg up for 20 mins? That doesn’t sound good. It must have become uncomfortable for her (and for you). Does your mare usually kick when having physio?

How can the horse be relaxed enough to benefit from the physio if it’s fighting having a leg lifted?

 

[Slightlyconfused]

Thank you, I really appreciate your response.
The vet checked the day after she went down on her knees. She may have rolled on a stone or something that I missed but I don't know.
There doesn't seem to be much heat in her knees now, she still looks stiff in her shoulders, I think or could be knees too, in trot though but that's prior to warming up aside from walking in hand around the school for 5 minutes and asking her to trot freely. She has had the last 2 months in very light work, first 2 weeks of it was just time off after physio and since then, it's been probably only once a week of either a 10 minute free school, just leading around over poles or a very short hack. I did ride her yesterday in the new saddle though and she was full of it as always. She's also been galloping around like a nutter in the field so not feeling too uncomfortable it seems.

Xrays from last year when I was getting her SI and back legs investigated showed extremely slight osteoarthritis in the hind pasterns which may also be a contributing factor along with being croup high and now 15 years old too so perhaps more wear and tear than normal. The SI injections showed no difference so it may be the arthritis or conformation causing the discomfort over that area too, maybe compensating on top of that with the front legs?

I just can't decide if it's worth it or if the supplement and regular physio will be the way forward anyway but I don't want the insurance to exclude it now that I've mentioned it but I also don't know if it's worth putting a claim in as that is still a risk.

Perhaps I'll get physio out again and a little more time off/in hand walking.

Thank you for your advice. ?

With what you have just written I would get the vet to do the images and anything else needed, at 15 there will come a time when the insurance wont do this so its best to get it done now.

Then once you have the images and a clear(ish) picture of whats going on make your choice. Steroid injections don't always work, they don't on me.

 

[Ellietotz]

They are taking the pee!

Your physio made you hold each front leg up for 20 mins? That doesn’t sound good. It must have become uncomfortable for her (and for you). Does your mare usually kick when having physio?

How can the horse be relaxed enough to benefit from the physio if it’s fighting having a leg lifted?

I know, its slowly gone from £22 to £30. It's still not much but considering it is hardly covering anything now, it is taking the P and I never thought about it!

Yes, she made me hold each front leg up while she treated the opposite side to prevent her kicking, although I don't think she would have, she can threaten but she wouldn't have been kicked when she is stood by her shoulder anyway. I'd say it was about 20 minutes, maybe a little less each side but it felt like it went on forever as I was starting to ache too. The amount of times she yanked her leg out as well, I was being told to try and hold on but she would end up really protesting, trying to rear up but only landing on the other leg that wasn't being held. So that probably hasn't done her any good at all coming to think of it. I thought it was to do with her treatment, it wasn't until I asked that I found out it was to stop her potentially kicking. She's treated her several times and not been kicked but she knows my mare can give her warnings.

I had a video of her free schooling in trot before the physio, she looks stiff but not terrible. Now she looks worse.

 

[FestiveFuzz]

Did you get any sort of discount on your premium to keep the policy running with all those conditions excluded?

Just curious, but surely they wouldn’t discount the premium as with that many exclusions the horse is clearly high risk from an insurance perspective?

 

[Tiddlypom]

It was meant tongue in cheek, really, but there is so little of the horse left covered that OP is right to query whether it’s worth continuing the policy once this latest issue is sorted. There will be more exclusions put on after this anyway, as vet has seen the knees and insurance company is also aware.

Just makes me even more glad that I now self insure and don’t have to put up with all this nonsense any more.

 

[FestiveFuzz]

It was meant tongue in cheek, really, but there is so little of the horse left covered that OP is right to query whether it’s worth continuing the policy once this latest issue is sorted. There will be more exclusions put on after this anyway, as vet has seen the knees and insurance company is also aware.

Just makes me even more glad that I self insure and don’t have to put up with all this nonsense any more.

Ah gotcha, sorry it’s been a long day! I self insure my older boy for much the same reasons now.

 

[clairebearnz]

One thing I would also x-ray if you're able to would be her neck as I would be somewhat concerned about arthritis there potentially causing the stiffness/stumbling due to nerve damage.

 

[Tiddlypom]

Yes, she made me hold each front leg up while she treated the opposite side to prevent her kicking, although I don't think she would have, she can threaten but she wouldn't have been kicked when she is stood by her shoulder anyway. I'd say it was about 20 minutes, maybe a little less each side but it felt like it went on forever as I was starting to ache too. The amount of times she yanked her leg out as well, I was being told to try and hold on but she would end up really protesting, trying to rear up but only landing on the other leg that wasn't being held. So that probably hasn't done her any good at all coming to think of it

That really doesn’t sound good, and very counterproductive for your horse. Dont use that physio again - she may be keeping herself safe which is fair enough, but not in a way which may strain and harm the horse (or you) .

It reinforces what has been suggested earlier, which is to get as much as is not excluded checked out as you can, the neck, the lot, while you can. That physio session could have hurt your mare - if it is as bad as you say, it could be worth an official complaint to her licensing body.

 

[ycbm]

The insurance has confirmed they will consider a claim for arthritis in the front legs and this isn't excluded.

They have said they will consider it, not that they will pay. But with the exclusions you quote (below) they have every right to refuse under the forelimb conformation and the croup high. I'm concerned for you that you don't end up with an unexpected bill.

Exclusions are ulcers, forelimb conformation (not sure what this would be), front feet (not sure why), croup high conformation, straight hind limb conformation, back and spine, osteoarthritis of pastern joints (havent specified which, might question them on this and why the front feet and forelimb conformation is excluded), enthesiophytes in hock joints, sacroiliac and "all related conditions".

 

[Ellietotz]

They have said they will consider it, not that they will pay. But with the exclusions you quote (below) they have every right to refuse under the forelimb conformation and the croup high. I'm concerned for you that you don't end up with an unexpected bill.

I'm concerned about this too. So I'm hoping the xrays for each knee and steroid injections won't be too much if the claim doesn't get accepted.

 

[Ellietotz]

That really doesn’t sound good, and very counterproductive for your horse. Dont use that physio again - she may be keeping herself safe which is fair enough, but not in a way which may strain and harm the horse (or you) .

It reinforces what has been suggested earlier, which is to get as much as is not excluded checked out as you can, the neck, the lot, while you can. That physio session could have hurt your mare - if it is as bad as you say, it could be worth an official complaint to her licensing body.

She is the physio the vet recommends too which is frustrating and she has usually done a good job. I just can't afford to get the vet out to sedate her every time and the physio won't treat her otherwise.

She did eventually say enough was enough as she was worried my mare's reactions were going to be counterproductive but it might have been too late by then.

The vet did check her neck too and didn't feel there was any cause for concern there. I'm just worried about racking up a huge bill and it being rejected by insurance.

I'm getting a reaction from her when pressure is applied over her chest but it's hard to know as she is overreactive anyway so I can't tell if the chest/shoulders are still the issue or the knees!

 

[Tiddlypom]

She is the physio the vet recommends too which is frustrating and she has usually done a good job. I just can't afford to get the vet out to sedate her every time and the physio won't treat her otherwise.

Was the mare sedated this time?

The forelimb confirmation exclusion does give the insurance company every opportunity to reject pretty much anything from the front end, as wonky legs can put strains on all sorts of things from the front end of the horse to the back. ’Considering’ a claim for the knees is not the same as ‘accepting’ the claim.

 

[Ellietotz]

Was the mare sedated this time?

The forelimb confirmation exclusion does give the insurance company every opportunity to reject pretty much anything from the front end, as wonky legs can put strains on all sorts of things from the front end of the horse to the back. ’Considering’ a claim for the knees is not the same as ‘accepting’ the claim.

She had Sedalin as I had some left but the physio was half an hour late so it had worn off.

I know, I am really concerned about it. My other option is to trial this boswellia/glucosamine/msm supplement for a month and get physio again to see how she is. I just really can't afford to put more on my credit card. Or the vet suggested Danilon for a month which is £63 but then what would that prove and what happens after if it works?

 

[IrishMilo]

@Ellietotz This will give you a rough idea. Recent invoice for mine. Your plates should be a bit cheaper as I told them to do neck and back as well as hocks. The column second to left is unit price, third from left is VAT.

 

[Tiddlypom]

She had Sedalin as I had some left but the physio was half an hour late so it had worn off.

That’s unfortunate, but the physio should have aborted the session when it became clear that the mare was so reactive. It was dangerous to proceed. The guidance for any professional involved in treating humans or animals is ‘do no harm’. Well, she likely did do harm by straining the horse and putting you in danger. That is a serious error.


A months Danilon trial will buy you time to think about your options. Many horses are kept comfortable enough for light work on a Danilon a day, so if it works, you could keep her on it. She clearly has had a lot of other issues in the past, and it may not be possible to fully fix her.

 

[Ellietotz]

That’s unfortunate, but the physio should have aborted the session when it became clear that the mare was so reactive. It was dangerous to proceed. The guidance for any professional involved in treating humans or animals is ‘do no harm’. Well, she likely did do harm by straining the horse and putting you in danger. That is a serious error.


A months Danilon trial will buy you time to think about your options. Many horses are kept comfortable enough for light work on a Danilon a day, so if it works, you could keep her on it. She clearly has had a lot of other issues in the past, and it may not be possible to fully fix her.

I know, I wish I had known why she was doing it.

Yes, that is true and £63 a month for one Danilon a day isn't disastrous.

I am so torn. Do I use the supplement I have for a month and get physio again and see how she is? Or just go straight in for Danilon, one a day for the foreseeable and physio again? A different one though! Or fork out for xrays and hope that the insurance covers it even though the end game will probably be the same management anyway?

I am so grateful for everyone's help here too. Thank you so much.

 

[ihatework]

I’d would be very surprised if your insurance pays out and if they do I’d like to know what company it is!!

Id honestly want to X-ray. I may or may not inject. But if you can’t afford to I most definitely wouldn’t be substituting Danilon/bute with supplements. I’d consider the supplements in addition but not in lieu of.

Plenty of arthritic older horses are kept going on bute/danilon. I do think though that best practise would be to know the extent of damage / diagnosis if you do intend to do that.

Longer term cheaper to get a prescription and buy on line if your vets aren’t competitive on pricing

 

[Tiddlypom]

Longer term cheaper to get a prescription and buy on line if your vets aren’t competitive on pricing

Reckon I pay £46/month for 1 sachet of Danilon/day by purchasing on line. That’s including the £25 cost of a 6 monthly prescription from my vet.

 

[Summit]

It was meant tongue in cheek, really, but there is so little of the horse left covered that OP is right to query whether it’s worth continuing the policy once this latest issue is sorted. There will be more exclusions put on after this anyway, as vet has seen the knees and insurance company is also aware.

Just makes me even more glad that I now self insure and don’t have to put up with all this nonsense any more.

I agree, I’d squeeze the last bit of insurance out, if the knees are covered, then cancel. Too many exclusions to make it viable

Bute is cheaper if the horse will eat it. Ive just paid £87 for 100 sachets

 

[Ellietotz]

Reckon I pay £46/month for 1 sachet of Danilon/day by purchasing on line. That’s including the £25 cost of a 6 monthly prescription from my vet.

Yes, I've just looked online and can get 60 sachets for £75 so hugely cheaper. Considering there is no heat in her knees now, the arthritis, if she has it, may not be too bad.

Looking back on her records and seeing as she has a small bone spur on her left hind hock and arthritis in the low motion pastern area, it wouldn't be a bad thing to permanently go down the Danilon route whether she has it in her knees or not either so maybe it would be okay to bypass the xrays... Do you think she would be okay with it considering she had ulcers in the past?

 

[Ellietotz]

I agree, I’d squeeze the last bit of insurance out, if the knees are covered, then cancel. Too many exclusions to make it viable

Bute is cheaper if the horse will eat it. Ive just paid £87 for 100 sachets

She does eat it but I'm worried about the effects it would have on her stomach as she has had ulcers in the past.

 

[Ellietotz]

So I THINK I've finally made a decision for the timebeing... I've figured that the xrays will only confirm what I think she already has and considering there is no heat now, I'm hoping it isn't that severe... so I will continue her on the supplement I've just started to see if there is any effect and see how she is when it's finished in a months time. If she is no better at that point then I will ask about putting her straight on Danilon as I'm not sure about injecting anyway as it seems it's a bit hit and miss with that plus the Danilon will help the arthritic pasterns and uncomfortable SI joint hopefully anyway if the knees weren't the issue in the first place. She seems fine to do her front leg stretches in terms of actually straightening her knee out now but to me, it doesn't look like she wants to stretch it properly through her shoulder, not her knees.
I'm not sure if or when to get physio again as I'd like to know if the supplement works before trying anything else. Think it looks like a long road but hopefully I can get my impatient-self to stop rushing everything and it'll be sorted soon!

 

[TPO]

I would get the xrays. At the very least it gives you a base level so you know how quickly/if the arthritis is progressing further down the line. You've already made the insurance aware theres an issue with her knees so they'll no doubt exclude them at renewal. Why pay insurance and not use it while you can?

Most oral supplements take at least 6wks to enter the system and have an effect. I'd want a proper diagnosis and treatment; arthritis hurts.

After the vet I'd get physio back. All the ailments you've mentioned will no doubt cause the horse to be compensating for reduced range of movement, discomfort and pain.

I'd check with vet and then physio if you should be continuing with certain stretches and ensure they are being carried out correctly considering pastern, knee and SI issues.

I don't see any benefit to the horse waiting 4-6wks to see if a supplement is having an impact. I personally would want to know the facts to make an informed decision about treatments and prognosis.

 

[Summit]

She does eat it but I'm worried about the effects it would have on her stomach as she has had ulcers in the past.

I’ve come across articles to say that Danilon is no kinder to the stomach than Bute. My vet confirmed this last week when I asked him. The extra expense is due to the fact it’s sugar coated

 

[Tiddlypom]

Is she normally difficult to handle, touch and groom? Wondering why she is so tricky for the physio that she has to be sedated for a routine treatment. I’ve known of horses being sedated for a necessary deep manipulation which would be uncomfortable, but not for routine treatments. IME they enjoy the physio/chiro, even my especially wonky mare does.

 

[Ellietotz]

Is she normally difficult to handle, touch and groom? Wondering why she is so tricky for the physio that she has to be sedated for a routine treatment. I’ve known of horses being sedated for a necessary deep manipulation which would be uncomfortable, but not for routine treatments. IME they enjoy the physio/chiro, even my especially wonky mare does.

She is fine to be handled, groomed etc. She is fine with the H-Wave and most of the routine treatment as well. It's only when they get to an uncomfortable spot that she doesn't like it but she doesn't kick out, she might tail swish, try to bite but I have her head or flick her bum up if it hurts but it's nothing horrendous. The uncomfortable area last time were her shoulders where the saddle had been slipping onto and that's when she had her legs held up. This is the only physio that makes me get her sedated. Other physios before have never had an issue or needed her sedated unless, like you say, they need to go in deeper. I think this physio is just safety paranoid because she is really not that bad but having one front leg held up for 15-20 minutes on the opposite side to where she is being pushed and prodded on a sore area, her balance from being pushed quite firmly would have been compromised and she was understandably uncomfortable, so I'm not sure I blame her.