Soft tissue damage....advice please

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annierae

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My 16yr old DWB X TB gelding Jack has been lame for about 2 months now. Long story short, we thought it could be a stifle problem so nerve blocked the stifle joint and that made no difference. We then nerve blocked the foot (left hind) and he trotted up 75% better. We then X-rayed the hoof and that all looked good, so my vet says it's most likely soft tissue damage. Jack is no longer insured as there were lots of exclusions on his policy (including all his feet) so I can't justify the cost of an MRI scan. (Vet bill so far is £900!) My vet has recommended 6 weeks box rest and bute to begin with and we are 3.5 weeks in. I had been keeping him and my old mare at home where I have mobile stables but no yard (yet) but at the beginning of this week, after lots of rain, I moved them back to work where there are stables and a big enclosed yard. Jack had a bit of a trot about in the yard on arrival, but has then been in his stable since. I have been letting him out for a wander on the yard while I muck out etc and I noticed yesterday he looked a bit stiff, then this morning when I let him out he looked really lame on that same hind and is resting it continually.
I'm waiting for my vet to phone me back for advice but I'm really worried. I hate keeping him in, he's the sort of horse that loves to be out and doing something and he also has arthritis in his hocks, although he never presented lame with that, just not 100% when schooling on the right rein.
I'm wondering whether I would be better off just turning him away over the Winter and seeing how he is in the Spring? I really don't want to keep him on box rest for months on end - particularly as he seems worse now than before!
Any opinions/experiences gratefully received. Sorry for the long post! Thank you.
 
The problem is you have no diagnosis so whatever you do may be detrimental to him in some way, box rest may be making his hocks more painful and that could be why he is worse now than before, but it is all guesswork, I often think if the injury is not acute then turning away is probably best for an older horse as long as they are sensible and don't tend to charge about but it is a risk that can go the wrong way.
 
He sounds like one of my horses a few years ago. We pinpointed the pain to below the fetlock (foot X-rays clear) and after some box rest he came sound, but then went lame 8weeks back into rehab. I did end up going down the MRI route and we found a tear to the DDFT which no amount of box/field rest was going to fix. In the end he had to stem cell surgery and he came sound again.

I really feel for you as it sounds like you can't afford the MRI but equally without a diagnosis it is going to be difficult to know whether turning him away for the winter is going to make it worse (especially if it is soft ground as if it is ligament damage it might make him worse) or if it will fix it.

I don't think we can really advise you what the best thing to do would be - if you trust your vet I'd go with their advice as to whether the think the bigger risk is his hocks (if you keep him in) or his foot (if you stick him in a field).

Another thought: Have you thought about trying something like thermography to pinpoint diagnosis (get a reputable company like SyncThermology who use actual vets to interpret the images). It may not help isolate the issue but it would be much cheaper than an MRI.
 
I would be thinking what about the 25% of lameness that did not disappear with the foot block .
Does he have a second issue that's not responding well to box rest for instance hock arthritis hates box rest .
 
Sometimes for things like this, if you're not going to pursue further diagnostics, the best thing to do is chuck them out for 3-6 months. Dr. Green and Dr. Time work wonders on those weird things.
 
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