Soft tissue injuries of the foot

[SillyMare]

Right - long story cut short:

Lexi - 6 year-old TB, eventing at PN / N level.

Last March she pulled a shoe off out cantering, shoe went back on a couple of days later. She was entered for Goring 2 weeks later - appeared to come sound in a few days so worked her lightly before the event then ran her at Goring.

Came home from Goring lame. Sound after a couple of weeks so I tried to bring her back to work. Went lame. Vet came and said bruised foot. Gave her a month off.

About a month later I tried to bring her back - initially sound but went lame after 3 or 4 days. Vet said work her a couple more days so she was 'properly' lame and he could nerve block.

This was early June - vet examined and found a pulse down to her foot. Nerve blocked foot and she appeared to come sound. X-rayed both front feet - perfect. He commented on what good confirmation she has (she is lovely and straight and all in proportion). His advice was that he still thought it was a bruise and I should get silicone pads under shoes and rest longer.

She is still lame but now intermittent. Vet has changed his mind about the bruised foot diagnosis (apparently inconsistent with intermittent lameness). She has been referred to Newmarket for a second opinion.

My vet says he thinks it is not a bone problem and not a bruise. Won't be drawn on soft tissue injuries.

So, what could it be? What sort of prognosis should I be preparing myself for?

 

[tillyd]

Is she going to have an MRI scan at Newmarket? MRI would show any soft tissue/ligament injuries in the foot, as opposed to just bony stuff that Xray shows . My horse recently had an MRI which showed fluid round coffin joint, which wouldn't have been diagnosed any other way. It also showed up some subsolar bruising (she's also got silicone pads now).
As to what it could be, maybe a strain of the ligament in the foot (can't remember which one it is that goes in there)? I imagine there's a few things it could be, but try not to worry too much until you know - I made myself almost sick with worry with mine, and it didn't change the result! Easier said than done I know. Fingers crossed it will be something easily fixable, like bruising (or even strained ligament isn't toooo bad). good luck.

 

[Jemayni]

My horse had all year off last year (well May 06 - Dec 06) with a soft tissue injury in his foot.

In some ways his lameness was similar to your horses i.e: there was no bony changes
And the degree of lameness has fluctuated but generally gone in the right direction.
Differences are:
My horse has a conformation that makes him susceptible to this injury.
My horse didnt go lame after a single incident but gradually went lame over 4 weeks or so....
However My horse was also lame in several places on both front legs - so the lameness would never have been identical.

Anyhow, we had a nightmare with diagnosis too; first vet we saw was rubbish, she was so adamant that there was nothing in the foot, (my horse is very difficult to nerve-block, so its difficult to get his foot to fully block out.) that she wanted to get shockwave treatment in his suspensory! When he started to go lamer again (October time) we took him to the head vet at the practise for a second opinion, who instantly suggested he had cartilage damage in the coffin joint, the joint was medicated and he was sound in four days, brought him back into work very very slowly & never had a prob since!

Now I just waffled on for 500 words, not sure whether it was that helpful; I wouldnt rule out soft tissue though, particularly seen as theres nothing on the bone, has your vet done the blocking out different bones in the foot think yet?

 

[SillyMare]

I don't know what tests they are planning at Newmarket - my vet said he thought they would start with nerve blocks.

Presumably they will work up toward and MRI if they haven't managed to identify the problem. I need special permission from insurance for that so it won't happen on Thursday.

Are all soft tissue injuries in the foot bad (ie nasty ligament problems that reccur when they come back to work) - seems to be the only kind I hear about!

As TillyD says above - working myself into a bit of a panic about this!

 

[cyearsley]

Apart from the fact that my friend has a very different horse (cob) and is not eventing (just a nice allrounder), you could be talking an almost identical case..... My horse has a tendon injury and is coming back into work after 8 weeks off and her horse has also been lame for 6 of these weeks.... The initial diagnosis was a bruise, he went lame, then went sound, then 10 days later went lame again, then appeared to be improving and then got worse again. She went the normal route of bute, box rest and farrier paring foot etc and intermittently it got better but the lameness kept returning. She had the shoes removed, reshod with pads etc etc all to no avail.
We are fortunate to live 1/2 mile from specialist equine vet, so last week he under went extensive xrays, nerve blocks etc etc on two seperate days, all of which were not conclusive. The xrays showed some boney changes around the pedal bone but nothing that would conclusively cause such lameness, the nerve blocking of the coffin joint showed a significant improvement but not soundness. He goes back next Wednesday for his MRI scan so will keep you posted. I'm not sure if any of this will help but thought it so similar had to add to the post. Good luck and try not to worry, I know it's horrible, have been through the emotional mill with my own horse and now with my friend, think at this rate will be getting my own parking space at the vets!!!

 

[tillyd]

With mine the order of things happening was nerve block foot (specific area in foot which includes coffin joints, but can't remember what its called). Went sounder (not completely sound - apparently the memory of the pain and other things means they rarely go completely sound straight after a nerve block). Then talked about the options - xray or mri. I knew in theory my insurance would pay the MRI so made sense to do that - I'd really push for that if you can, otherwise you might get inconclusive results from just xrays which is no good for your wallet or mental state!

My insurance also needed a report from the vet faxed over to them to approve - it was just a short paragraph saying he thought mri was the best diagnostic choice. Who are you insured with? KBis, that I'm with were very good and quick in approving.

They then kept mine in overnight and MRIed the next day. They have to be very heavily sedated for mri, as it takes about 4 hours all told, and if they move at all they have to start the process again. Also takes the vet a while to analyse the images (there's hundreds of them apparently). And then when they knew all the images were clear enough or whatever, I had the ok to collect my horse the following day.
Fingers crossed for you, I know you are probably thinking the absolute worst like I did, which is human nature, but not very logical, so try not to put yourself through the mill too much. Let us know what happens.

 

[Jemayni]

Well best of luck, whatever happen!

And no I dont think they're all long-term issures, my horse has been fine since xmas, & he has rubbish conf to exasperate the problem, much better prognosis than a boney change anyway

 

[SillyMare]

Thanks everyone.

Lexi is with KBIS too - I need to call them from Newmarket tomorrow when I know what tests are needed. I was aiming to push for an MRI if I can - really want to come back with an actual diagnosis.

Please keep your fingers crossed for us tomorrow!

I'll let you know what happens.

 

[Kelso756]

I too seem to have a soft tissue injury. We are in Canada and the MRI is $1200.00. We discovered navicular changes in right front and then he went lame on left front. I THINK it is from compensating for the right for a lengthy time, while we solved that. I am slowly bringing him back with linements and light excersise, hoping it was a strain or sprain. Interested to know how they treat your soft tissue injury. I am probably still headed for the MRI but would sure like to save the expense and long travel
Good luck and I look forward to continuing this subject