Annagain
Well-Known Member
Sorry, another long one. My horse has been lame for a while - first on the left fore and now on the right (vet thinks he has overcompensated). The first time we went for nerve blocks and x-rays, the first one worked and we x-rayed the heel area, which showed no major damage, it was all quite straightforward.
This time, the first nerve block accounted for 90% of the pain but he was still showing up a bit lame when lunged in a tight circle on a hard surface. He therefore gave me the option of blocking the whole foot or going straight to the coffin joint, but recommended the whole foot first as there is always a risk of introducing infection into the joint. We did that and he came sound, and the x-rays he took didn't show any problems He's 80% sure it's just a strain but wants to go into the coffin joint just to be certain.
He's given me the option of two weeks field rest and bute to see if he comes sound or blocking the joint on Friday and medicating it straight away if it is the problem. His reasoning is that he will need rest anyway after going into the joint, so by doing it now we combine the rest for the two things. If he's not sound after the two weeks, he will have to have the joint blocked anyway and then require more time off. This isn't just inconvenient for me, it could also prolong his lameness or even make the injury worse.
Normally I would go with the vet's recommendation straight away, but I'm not convinced the 1st nerve block took effect completely. The reason I say this is because Archie fidgeted a bit and a lot of the local anaesthetic escaped the syringe. The vet put more in, but when he tested his reaction ten minutes later, there was a very slight reaction. It was nothing compared to the other leg, but when he did the 2nd block later there was no reaction at all. I'm wondering if he didn't quite have enough the first time and that's why it was 90% better but not completely, rather than there being another problem in a different part of the foot. There is risk involved in giving him an unnecessary joint block, but there is also risk involved in giving him two weeks and seeing how it goes. Cost isn't an issue as insurance have already paid out, so they will pay for anything else he needs done for it.
What would you do?
This time, the first nerve block accounted for 90% of the pain but he was still showing up a bit lame when lunged in a tight circle on a hard surface. He therefore gave me the option of blocking the whole foot or going straight to the coffin joint, but recommended the whole foot first as there is always a risk of introducing infection into the joint. We did that and he came sound, and the x-rays he took didn't show any problems He's 80% sure it's just a strain but wants to go into the coffin joint just to be certain.
He's given me the option of two weeks field rest and bute to see if he comes sound or blocking the joint on Friday and medicating it straight away if it is the problem. His reasoning is that he will need rest anyway after going into the joint, so by doing it now we combine the rest for the two things. If he's not sound after the two weeks, he will have to have the joint blocked anyway and then require more time off. This isn't just inconvenient for me, it could also prolong his lameness or even make the injury worse.
Normally I would go with the vet's recommendation straight away, but I'm not convinced the 1st nerve block took effect completely. The reason I say this is because Archie fidgeted a bit and a lot of the local anaesthetic escaped the syringe. The vet put more in, but when he tested his reaction ten minutes later, there was a very slight reaction. It was nothing compared to the other leg, but when he did the 2nd block later there was no reaction at all. I'm wondering if he didn't quite have enough the first time and that's why it was 90% better but not completely, rather than there being another problem in a different part of the foot. There is risk involved in giving him an unnecessary joint block, but there is also risk involved in giving him two weeks and seeing how it goes. Cost isn't an issue as insurance have already paid out, so they will pay for anything else he needs done for it.
What would you do?
