Rough cost please

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mudmonkey17

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What would be a rough cost of a lameness workup with possibly xrays and nerve blocks?

Horse is unlevel in back end and physio and instructor think may be his hocks causing the stiffness. Has had one hock injected around 4yr ago with previous owner so is most likely bone spavins causing the increased stiffness.

Problem is now going to get vet out and while i want him to be sorted and as comfortable as possible to carry on ridden work, at a lower level than now, i dont want to have to pay out thousands of pounds as his insurance doesnt cover arthritis.

Any information appreciated.
 
I am not sure of costs but get your vet to come out to do nerve bocks and xrays,not come once to have a look and then come back to do a work up, as often seems to happen.
Tell them you have no insurance and they should not run up a load of tests that are not needed.
 
Have you done your own flexion tests? They are easy and should give you a good idea if his hocks are hurting him. On a flat surface ( a quiet road is good!) hold his leg bent as much as you can get the hock bent. Try not to bend the fetlock at all, and the stifle as little as possible. Keep the hold on for 45 seconds and then trot him off. If his hock is a problem he will be hopping lame for quite a few strides. Then forget the nerve blocks, because with failed flexions and his previous history it will be money probably wasted, and the xrays won't help much either - they are either fused but still painful or not fused. Ask your vet what difference to the treatment xrays will make and if, as is likely, he says "none" then go straight for treatment. With no insuance and wanting to keep the bill down, the only real treatment option is steroid injections, for which I have just been quoted £150 for both on my own spavined but un-xrayed, un-lameness-workupped uninsured horse.
 
I don't think many vets would inject without doing xrays first. To give you a rough idea my horse spent 2 days last year at the vets for a lameness work up, multiple nerve blocks, then xrays, then steroid injections into the hock. He also left with a supply of pain relief, bill came to just over 500.
 
Shearer said:
I don't think many vets would inject without doing xrays first.

To give you a rough idea my horse spent 2 days last year at the vets for a lameness work up, multiple nerve blocks, then xrays, then steroid injections into the hock. He also left with a supply of pain relief, bill came to just over 500.
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Plenty will in Cheshire. The magic words you need to say are "this horse is not insured".

I asked my vet if all the workup that your horse had would actually change how we would treat him, and he said no, we would still end up using steroid injections as the treatment. So what was the point of most of the 500 of your money or your insurer's money that your vets spent, I wonder. That's why insurance is rising so much, all these tests that don't actually change the treatment.
 
last year my horse had a lameness work up, 1 set of blocks and a few of x rays and it came in at just under £400, no call out fee though as I took her to the equine clinic.

She recently had another full workup as still not 100% sound, this time she stayed with the vets so that they could carry out various blocks (time required between blocks for them to wear off).

She had 3 sets of blocks (hocks, stifles and full legs)
x rays to both hocks
Scans to both stifles
sedatives etc for x-rays
3 days board, nurses care etc

and it was to £1,600!

So it all depends on whether they can pin point the problem straight away, it sounds like you know it's the hocks so you would probably be around the lower figure.
 
Thanks for all the replies it is really helpful. Think would lean towards wanting x-rays still though.

The physio thought was bilaterally lame but worse on left. However he is tender on right hock where he got kicked a couple of months ago and kicks when brushing it etc.

Could this have aggrivated something or just a coincidence? Wasnt lame with the kick at the time though was around the time he started running out at jumps so looking back maybe he was sore.

Guess won't know until vet comes, gonna be a long wait :(
 
Injecting a joint when you don't know what the problem is is completely pointless though! A vet can still be understanding about lack of insurance, but an xray is the only way you can really diagnose bone spavin.
 
Shearer said:
Injecting a joint when you don't know what the problem is is completely pointless though! A vet can still be understanding about lack of insurance, but an xray is the only way you can really diagnose bone spavin.
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I agree with your sentiment i.e. how do you know where to inject without a diagnosis, but x-rays are not the most sensitive tool for diagnosing bone spavin. Injecting local anaesthetic into the joint is the only way of knowing that's where the pain is coming from - there are thousands of sound horses with horrible looking x-rays and vice versa.
 
Shearer said:
Injecting a joint when you don't know what the problem is is completely pointless though! A vet can still be understanding about lack of insurance, but an xray is the only way you can really diagnose bone spavin.
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Not pointless at all.

Common things are common. The commonest cause of hind limb stiffness in a horse of this age, especially when it has a previous diagnosis, is hock spavin. The commonest treatment for hock spavin, after a bit of bute, is steroid injections. If you give steroid injections to a horse that fails hock flexions you are very, very, very likely to be doing the right thing, and there is precious little downside to it if it is not the right thing.

Besides, as Alsiola (a vet) has kindly explained, like "navicular" the xrays bear little relation to the soundness of the horse. I had a horse who was bilaterally lame whose xrays were completely clear after more than a year of on-off lameness, even though he was throwing visible spavin lumps externally.
 
If you can find me someone who can flex a horse's hock without also flexing stifle and hip then I'll be impressed! Bear in mind that many ligament and tendon problems (suspensory ligament desmitis being the most common/important) will also be worsened by flexion of the limb.
The hock has 4 distinct joints (tarsocrural,proximal intertarsal, distal intertarsal and tarsometatarsal) with extremely variable communication between them. How do we know which one to inject?
As mentioned above, there are side effects of steroid injection as well - they will usually speed up the degeneration of cartilage within the joint. I tend to regard them as a short term fix, with long term detriment. Laminitis has never been scientifically proven to be a side effect of steroid administration, although anecdotally it is often cited. I have to say I think the risk is very low in active horses of normal weight.

If clinical findings are such that spavin is strongly suspected, then I would at least be strongly encouraging your vet to inject steroid and local anaesthetic together - that way the joint is medicated and you get an answer as to whether that joint is the problem, at very little additional cost. (LA would be £10-20) Definitely a help for future management.
 
Think i would still rather have a better idea of what was going on before i had a vet stick needles in (possibly unnecessarily) either by having nerve blocks or xrays done. My horse wasn't insured either so i fully understand the idea of trying to keep the bill down, in my horses case we knew the chances of bone spavin were quite high before he was nerve blocked or xrayed but it was worth having the xrays done just to show the extent of the problem as it turned out steroid injections were fairly pointless at the stage he was at so he had alcohol injections instead.

ETA that was in response to cptrayes i was too slow replying!
 
I've recently had it done and cost was almost £400. I didn't have a starting point so I got Clare out from the Inner Picture to do a Thermal Image. Once vet saw heat in heels he nerve blocked then x rayed.

www.theinnerpicture.com

I'm sure your vet could give you a cost if you asked.
 
alsiola said:
As mentioned above, there are side effects of steroid injection as well - they will usually speed up the degeneration of cartilage within the joint. I tend to regard them as a short term fix, with long term detriment. .
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I understood that long term soundness depends on cartilage destruction and fusing of the joint, so is there really a long term detriment? Given that other treatments are mechanical or chemical removal of the cartilage why does it harm to remove it with steroids?

Quite a few horses I hunt alongside are routinely injected with no xrays or any other diagnostics than flexions. A horse I once owned, who is now in the US, has just been done too. I thought the joints were all contained in the same pool of joint fluid, so I've learned something new there if they aren't.
 
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