Potential Arthritis - what should I do?

[Ellietotz]

So the vets have confirmed the knee xrays will be £260 total. However, I still don't think I'd go down the injection route and I'm leaning more towards daily Danilon instead as I won't be able to afford injections everywhere else too as seeing as she has arthritis in her hind pasterns, it just covers that as well just going straight on painkillers.
I asked for some advice on the PSSM support group too who think it might be navicular or pedal osteitis possibly which again, would all still be managed with painkillers IMO.
So I'm still just stuck on my decision as with whatever it is, the answer to everything is still going to be the same so is there any point having the xrays when my decision on after management is still the same?
I am going to get a cushings test too, I don't think she has it but would be better to rule it out.

 

[Pearlsacarolsinger]

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.

I would find a different physio tbh.

 

[Wheels]

I would definitely get the xrays done as otherwise you don't know what you are dealing with and what if it's not the knees and the xrays rule those out? I understand what you are saying re. the other areas and that danilon can help those too but if your horse has had ulcers previously I would not want to us danilon long term (or even at all if it could be helped.)

If the insurance will pay for the xrays then why will they not pay for the steroid injections?

 

[Ellietotz]

I would definitely get the xrays done as otherwise you don't know what you are dealing with and what if it's not the knees and the xrays rule those out? I understand what you are saying re. the other areas and that danilon can help those too but if your horse has had ulcers previously I would not want to us danilon long term (or even at all if it could be helped.)

If the insurance will pay for the xrays then why will they not pay for the steroid injections?

There is no guarantee the insurance will pay out at all. They only said they'd consider it for the knees only. If the xrays were done and arthritis isn't found, I just could not afford to get anything else done as the insurance definitely won't consider anything else. The only option really to me is painkillers. I understood Danilon was safe for ulcer prone horses though.

 

[TPO]

So the vets have confirmed the knee xrays will be £260 total. However, I still don't think I'd go down the injection route and I'm leaning more towards daily Danilon instead as I won't be able to afford injections everywhere else too as seeing as she has arthritis in her hind pasterns, it just covers that as well just going straight on painkillers.
I asked for some advice on the PSSM support group too who think it might be navicular or pedal osteitis possibly which again, would all still be managed with painkillers IMO.
So I'm still just stuck on my decision as with whatever it is, the answer to everything is still going to be the same so is there any point having the xrays when my decision on after management is still the same?
I am going to get a cushings test too, I don't think she has it but would be better to rule it out.

I'd speak to your vet and discuss the various options available to you. You're going to have to involve them regardless for a danolin prescription and they might have their own ideas about what should be done before they prescribe anything. IMO it's better to gather all the information and options then make an informed decision than take a scatter gun approach. You'll spend your xray money on supplements and other testing in the blink of an eye.

I dont mean to sound blunt but theres little point spending on a Cushing's test or barefoot transition if things dont look well on a knee xray. In your position I'd want to know what I'm dealing with and it already sounds like your horse has a lot going on.

I'm sure randoms on the internet, myself included, mean well but they arent vets and havent seen your horse. The symptoms you describe will ring bells based on other peoples personal experiences and that's why you'll get a myriad of "could be" from psd to navicular. I understand the clutching at straws but sometimes there are no miracle cures. I've been where you are, right down to slight heat and swelling in a knee. My horse was retired already by that point and as always it's a big long story with little relevance but he too had a list of issues. He was field sound and not on any meds when a so slight no one else could see or feel shortness and heat appeared in a fore. Other events overtook things so a decision was made whilst not in direct response to the arthritis but knowing it was lurking in the background degenerative and at 16 things were only going to be downhill from then in for him.

You've done well to get your horse to 15. The croup high conformation coupled with the SI and hind end issues would always have put extra strain on the fore limbs. It's not surprising that something was brewing and that the fall has exacerbated it and brought it to the fore.

So yes I'd speak to your vet and find out most effective (including cost effective) way to get a diagnosis and more importantly a prognosis. Then make an informed decision about the best way to proceed from that point

 

[Wheels]

There is no guarantee the insurance will pay out at all. They only said they'd consider it for the knees only. If the xrays were done and arthritis isn't found, I just could not afford to get anything else done as the insurance definitely won't consider anything else. The only option really to me is painkillers. I understood Danilon was safe for ulcer prone horses though.

no, it's not unfortunately. It can be very tough on the stomach

 

[ihatework]

I agree with TPO and also, trying my very best not to be blunt and upset you, but your mare sounds like she has reached the age where she is going to need intervention and management and it’s not going to come for free. It’s that stark reality of horse ownership. So I do think you will need to really consider what you can fund long term, because with the multiple issues she has there will come an ethical line whereby you will either need to spend the money or consider the alternative.

Hopefully bute/danilon will make a positive impact. I hear your concerns about ulcers. I know it’s contra indicated for horses with active ulcers but there is limited evidence that it induces ulcers. Ulcers form as a result of stress and a horse in constant low grade pain is under stress. Mitigate that with bute and there is a chance (no guarantee) that you will reduce the likelihood of recurrence.

 

[Ellietotz]

no, it's not unfortunately. It can be very tough on the stomach

Bugger.
My issue is that she has problems elsewhere too and I couldn't afford to inject all the places she might need it so I don't know what my other options are. The vet said injections or painkillers. I could try a good supplement but it might be another waste of money if it doesn't work either. The vet said a supplement isn't a substitute for it too but then he also said at the time of his last visit that a few of his clients have managed to come off bute and have success with Nutraquin. I'm really at a loss.

 

[Ellietotz]

I agree with TPO and also, trying my very best not to be blunt and upset you, but your mare sounds like she has reached the age where she is going to need intervention and management and it’s not going to come for free. It’s that stark reality of horse ownership. So I do think you will need to really consider what you can fund long term, because with the multiple issues she has there will come an ethical line whereby you will either need to spend the money or consider the alternative.

Hopefully bute/danilon will make a positive impact. I hear your concerns about ulcers. I know it’s contra indicated for horses with active ulcers but there is limited evidence that it induces ulcers. Ulcers form as a result of stress and a horse in constant low grade pain is under stress. Mitigate that with bute and there is a chance (no guarantee) that you will reduce the likelihood of recurrence.

Of course, I do understand that. I'm just trying to consider the most cost effective but best thing for her. She already has low grade arthritis in her pasterns and a bone spur in her hock along with SI pain which steroid injections didn't do anything for last time. I just feel it would be pointless just injecting the knees if they are affected and not everything else too but they didn't work before for the SI and could just end up being a waste of money. Even if her knees aren't affected too, she still has the other issues. To me, the better option is a blanket painkiller that will hopefully sort everything rather than multiple injections that may not work.

I am happy with the Danilon route if I am assured her stomach should be okay. I do feel this is best for her to cover the rest of her issues and keep her happy for the remainder of her life.

I know a lot of people have had success with msm and boswellia but is it worth seeing if this even works first?

 

[southerncomfort]

If it helps, expensive supplements are unlikely to make much difference at this point when she already has active arthritis, so I'd not invest in any more to be honest.

It sounds like you are erring towards not doing any more diagnostics and concentrating on pain management instead. And that you are also dubious about the cost and effectiveness of injections. If that's the case then I would definitely go with daily Danilon. At the end of the day she is sore, and at this point with all her various issues, you need to control that pain. It may or may not cause stomach issues but I guess at that point you either medicate the ulcers or you decide that her various conditions are no longer manageable

I really feel for you, you are clearly agonising over this.

 

[IrishMilo]

Of course, I do understand that. I'm just trying to consider the most cost effective but best thing for her. She already has low grade arthritis in her pasterns and a bone spur in her hock along with SI pain which steroid injections didn't do anything for last time. I just feel it would be pointless just injecting the knees if they are affected and not everything else too but they didn't work before for the SI and could just end up being a waste of money. Even if her knees aren't affected too, she still has the other issues. To me, the better option is a blanket painkiller that will hopefully sort everything rather than multiple injections that may not work

I understand your approach. I think if everywhere else was fine I'd say definitely get the knees X rayed and treat as extensively as you can, but that's obviously not viable for you financially. Sorry to be morbid but at 15 and with all of the issues you mention, plus your constrained finances, I would probably be seriously considering PTS. She has a fair few pain points going on which are only going to get worse. I know it's easier said that done though - I always thought I'd make a goner of anything I owned that turned out to have something degenerative, and now I have one and I want to do everything I can to make him OK.

 

[Ellietotz]

If it helps, expensive supplements are unlikely to make much difference at this point when she already has active arthritis, so I'd not invest in any more to be honest.

It sounds like you are erring towards not doing any more diagnostics and concentrating on pain management instead. And that you are also dubious about the cost and effectiveness of injections. If that's the case then I would definitely go with daily Danilon. At the end of the day she is sore, and at this point with all her various issues, you need to control that pain. It may or may not cause stomach issues but I guess at that point you either medicate the ulcers or you decide that her various conditions are no longer manageable

I really feel for you, you are clearly agonising over this.

Thank you. I really am and I feel like I'm being so annoying but I just don't know what way to turn.

You are exactly right, I could get her knees xrayed and they may be clear but I am still going to have to manage pain somewhere else and I wouldn't be surprised if she had arthritis or issues in several other places amongst all her other ailments.

She gets fed copra, linseed and grass chaff with salt, vitamin e and balancer. I just hope that is enough to protect her stomach.

I was just debating changing my mind again and trying my vets supplement Nutraquin + to see if that works before risking her stomach becoming sore. I just wish my brain would stop sometimes.

 

[Tiddlypom]

You could try a Danilon trial and see what happens.

We ran one on my 9yo, she became so reactive that she was dangerous. It turned out that she had hind gut ulcers, not foregut ulcers, and bute/Danilon aggravates hind gut ulcers. They are now managed by feeding her Succeed supplement.

(She has since had her front coffins, hocks and SI medicated at a cost of ££££s, and *fingers firmly crossed* is doing very well.)

Ask your vets about a Danilon trial.

 

[ester]

When they are having multiple issues, in multiple joints I think it makes more sense to go down the bute trial route than trying lots of injections straight of.

Boswellia is great but it's effects are not as great as those of bute.

 

[Ellietotz]

On a side note, my insurance policy says no illness cover for horses 15 or over. Their definition for illness is physical disease, sickness, infection or failure which is not caused by injury. Does that mean even things like colic now aren't covered? Exclusions also are gastric ulcers and any related conditions.

 

[Tiddlypom]

If ulcers are excluded, then colic is usually excluded too, under the ‘any related conditions’ cop out.

 

[milliepops]

If ulcers are excluded, then colic is usually excluded too, under the ‘any related conditions’ cop out.

this
I think you're throwing your money away on that policy, sadly.

 

[Ellietotz]

this
I think you're throwing your money away on that policy, sadly.

Yeah, I thought that might be the case. I guess injuries would be covered though? Probably not worth the rest of the premium though.

 

[milliepops]

Yeah, I thought that might be the case. I guess injuries would be covered though? Probably not worth the rest of the premium though.

depends how much it is, you might be better off with one of the catastrophe type policies if you want to continue insuring.

 

[Ellietotz]

depends how much it is, you might be better off with one of the catastrophe type policies if you want to continue insuring.

Yes, I may look into this instead.

On another side note, should I get a cushings test when the vet comes too?

 

[Ellietotz]

Well, a little update...
I rode her tonight just for a short hack as her knees aren't warm anymore and she felt lovely and floaty. I let her go at whatever pace she chooses but make sure the ground is soft and it is controlled but it means I'm not pushing her and she is doing what she is comfortable with. She wanted to trot so badly on the tiny bit of road at the end which was different to before when she was avoiding it on a ride a couple of weeks a go but I told her she was an old lady now so she had to be careful with her dodgy knees now! ? Hopefully got the physio next week, vet with their Nutraquin joint supplement that I'm going to try first before potentially compromising her stomach with painkillers and considering she seems pretty fully of herself, I'm hoping it'll be manageable. I'm going to get cushings test done too just to rule it out so fingers crossed.

 

[Ellietotz]

So there is definitely no heat in her knees now. The farrier came this morning and said her front right was warm and had a bruised sole and that was without mentioning anything about her being lame on that one.
However, she has been mildly lame on that one for 7+ weeks so surely it can't just be that? He said there is no sign of laminitis or abscess either.
I'm wondering if it's potentially something else and not arthritis at all.

 

[Goldenstar]

My experience is many horses have arthritis and it is easy to find and manage it’s soft tissue issues that are hard to find and harder to manage .
I am not sure what the way forward is it’s a very difficult situation to be in .

 

[Ellietotz]

My experience is many horses have arthritis and it is easy to find and manage it’s soft tissue issues that are hard to find and harder to manage .
I am not sure what the way forward is it’s a very difficult situation to be in .

I just wish she could talk!
I suppose for all I know, it could be a mix between the saddle causing a couple of years of damage despite regular saddle checks, bruised soles, arthritis and the physio making me hold her front legs up resulting in her yanking her legs out, mini rearing to get free and landing all her weight on the opposite leg! She doesn't seem miserable and is still happy galloping about in the field!

 

[Frumpoon]

Most front limb lamenesses emanate from the foot so I think xrays of the knees are unlikely to help you

Likewise one stumble does not a lame horse make

Sorry I haven't read all the replies but is she sound and can you afford another saddle?

 

[Tiddlypom]

You won’t be using the same physio again, will you?

 

[Ellietotz]

You won’t be using the same physio again, will you?

Definitely not. Have been speaking to another one but not sure she is going to come back to me knowing my mare can be sensitive to treat. ?

 

[Ellietotz]

Most front limb lamenesses emanate from the foot so I think xrays of the knees are unlikely to help you

Likewise one stumble does not a lame horse make

Sorry I haven't read all the replies but is she sound and can you afford another saddle?

Yes, we have a saddle now but she still looks stiff on the front in trot when free schooled. Perhaps it is still the last saddle causing this but I haven't used it since it was sold on 2 months a go. She looks stiff on the front when trotting in a circle on the right lead but looks hobbly on the front right in particular on the left lead. Not so much in a straight line.
The farrier didn't find any heat in her feet 7 weeks a go but found a bruised sole in the front right today and warmth but no sign of abscess.
No heat anywhere else or swelling in her legs but I think her shoulders may possibly be sore still which I initially thought was the saddle.

 

[Ellietotz]

The picture with the saddle cover on was 2 years a go and the one without was 2 months a go. The previous saddle fitter told me it was the perfect fit... I guess it's my fault too for trusting her.
It was this front teardrop section when the discomfort was found when the physio came out.

ETA the back of it on too. It is sat wonky because she was looking round at me but you get the jist of how wide the panels "hugged" her back.

 

[Frumpoon]

Where are you Ellie?