steroid injections when not lame ?

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horseandshoes77

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Hi my mare came in from field slightly lame on hind leg with a small swelling just above ankle, not much heat and she was only lame for 24 hours anyway when vet camehe said cold hosing and box rest until he could get out to do xrays and ultra sound.
Both of these were done and he said it looked promising poss only sprain or strain.
She has had 4 weeks rest boxed at night and out in very small paddock during day, not lame at all and no heat she is weight baring and doesnt seem to have pain in it, vet rang yesterday and said he wanted to come out and give her steroid injection, when i questioned this he said she may have ligament damage and djd?
Now she is insured and i dnt mind doing anything that will help her but surely if shes getting better should we not let time heal and put her back into work to see if this would flareup again before going down the route of steroids, he also said she may need surgery but thats a while off yet.
im just baffled at how all this wasnt told to me after xrays etc

im not sure what the steroids would do when theres no swelling or pain?

any advicemuch appreciated.
 
Degenerative Joint Disease is when the cartilage which protects the joints starts to breakdown. Is your mare a heavy breed or quite old?

It's not correct for me to advise, not knowing you or the mare, or what type of work you do with her, and obviously you need to discuss with your vet, but I think if she was one of mine, who'd come in lame with a puffy fetlock, and the lameness & swelling had gone within 24 hours I would probably hold off the cortisone injections for now.
I would monitor her closely, and, and if she starts to show unsoundness again, perhaps think about starting treatments then after discussing the xray and scan results with the vet.
 
Hi my mare is 16.2hh tb x id she was 9 in may she hasnt done much at all her whole life to be honest, broken at 5 yrs then in work for a year then in a field for 2 years then to me and she has done hacking and a little jumping.

To be honest what gets me is the vet when did xrays and ultra sound said he was amazed at what good shape her legs were in...hence the remark that he thought all was well and just rest.....then without xraying again or even seeing her again.hes now saying she has djd and ligament damage ?

Im just very concerned about him maybe treating her with as much as he can because he has 5000 insurance to play with.
 
Did you look at the x rays and the scan? the vet should have gone through the findings with you before any treatment, if a horse has Djd it will show up on the x ray and ligament damage may show on the scan if its bad enough, if it is just a sprain it should heal on its own.
Unless he can show you evidence of either I would not proceed with the injection unless the vet can give good reason to give it.
 
"I'm just very concerned about him maybe treating her with as much as he can because he has 5000 insurance to play with. "

I'd be as concerned as you. If he treats her, then your insurance will exclude that leg or even both back legs. If she does not actually have DJD or a ligament strain showing on scans/xrays, then you will lose cover for no reason.
 
cptrayes said:
"I'm just very concerned about him maybe treating her with as much as he can because he has 5000 insurance to play with. "

I'd be as concerned as you. If he treats her, then your insurance will exclude that leg or even both back legs. If she does not actually have DJD or a ligament strain showing on scans/xrays, then you will lose cover for no reason.
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Agree....and no no no no no to the steroids!!!:eek:

I'm all for steroids if needed but THIS is the classic no inflammation case that means the steroids have nothing the work on and so float around until they find something to do....enter side-effects....(shhh - don't look now, did someone say laminitis again??!!!! :D)

I can't see any justification for the steroids clinically as your horse is fine....so you feel at least. The vet also agreed....and now have reappeared putting doubts of DJD on the table. I trying to think of why the vet's taking this approach.

Try asking simple questions....first does my horse have signs of DJD on the xray? If there are but it is currently asymptomatic can you really justify treating it now?

Don't let the insurance reasons swing you...if she has early signs but no lameness I still wouldn't treat now. Plus the history fits more with trauma...

Just my 2p - better get back in my box now :D
Imogen
 
I cant see how the vet can suggest steroid injections when there is nothing wrong with her, if it were me i would get a second opinion on the x-rays and scans. Do you know where he was planning to put the steroid injection or was he just going to have a game of "pin the tail on the donkey" with the poor horse and then send the bill on to the insurance company, T**T!

Rant over, was going to say that i hope your mare gets better soon but seeing as your post says she is fine now i wish you many happy sound and fun packed years with her!:D
 
In any case, the next time the insurance company gets a vet report this will be on it and they will probably exclude the fetclock anyway.

My horses are excluded for all sorts of things they have never had a claim for - they got one vet history report and went through it looking for things to exclude. Of course I "discussed" it with them and negotiated them down to a more reasonable exclusion, but be aware that even if you don't make a claim an exclusion is highly likely.

One of mine was excluded for his whole head and neck, because he banged his head on the hay ring and got a large haematoma. That was negotiated back to "any problems resulting from or traced back to that specific accident" - you have to watch them and be very tough.
 
Hi everyone thanks for replies.....this leg will be excluded now as the claim is open asthe xrays and ultrasound and sedation etc he did at last visit came to 800 so i went through isurance, and i did see the xrays and he said there was nothing to be concerned about, he even said he was amazed at how well her legslooked for her age.

im just thinking hes now got 5000 for 12 months to treat her and maybe just wants to spend it all, dnt get me wrong if she needs to have treatment i would have it asap but im not convinced this injury is all that bad and i certainly dnt think she has djd as he would have said that at the initial stage.

im going to let him come out and check her on tuesday and if he wants to do anything else with her im going to get second opinion first.....should i speak to insurance if i want second opinion first or will i have to pay for that seperate ?

ty
 
Personally before you proceed any further with treatment you need an actual diagnosis. The vet cant go from saying she has clean legs to having such problems without any further investigation. It makes no sense!
I would firstly ask the vet to clarify things - explain to him that he told you at first things looked ok, and how do they not know? Maybe he simply hasnt explained himself well enough.
Secondly if you are still unsure, contact your insurance company, and then get a second opinion.
To me, from your description, it sounded like she had had a knock out, got a bit of bruising and then it had settled down again. If it was anything else why would the vet had not said at time of x ray?
All sounds very odd!
 
Well, I'm an old Scottish cynic....

But I always see a flurry of activity from the vets about 8 months after the initial claim - best to check up, re-run the xrays etc....

I tend to look on it as their having my interests at heart and trying to do the right thing by me, but that lingering bit of suspicion always remains :D.
 
Maybe seek a second opinion if the diagnosis and reasons for treatment has not been made clear?

Although your horse is ok now, she can't have been right for the Vet to come and scan/Xray/advise 4 weeks box rest in the first place?, (just being devils advocate here)so sounds like maybe your Vet may not have explained everything clearly to you, as pherhaps they could have done? Did he say ligament damage or cartilage damage?- one of my horses in the past damaged cartilage and he did have joint injections which were v useful in recovering him, but steroids were not used.

I'd be wanting to know exactly what the horse is being treated for, with some kind of plan worked out. If it's DJD then I can see why a cortisone injection might be used I guess, but I'm not a Vet!!

Cortisone(steroid) injections can be really helpful I think and a preventative too, if you are clear as to what it's being used for in the first place.

I'd be asking the Vet for further clarification and asking if he can explain it further by going over the xrays in more detail.
 
Cortisone(steroid) injections can be really helpful I think and a preventative too
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I think Imogen will probably wade in here - but I don't think steriods are used as a preventative - ever. That's not their function, and a kind of dangerous thinking route to go down imho.
 
can i just say.....phoned vet when horse was lame and had swelling....came saw said let run in field and in 2 days i will come xray etc....so i did, she came sound swelling went dwn no heat etc etc, then had xray and ultra sound and vet did it all on site and showed me xrays and ultra sound and his very words were im so pleased looks like just a sprain or strain at worst a pulled ligament but i doubt it, then he said just rest her in small paddock in day in at night, ill see her in 4 weeks......hence 4 weeks later vet rang saying he wants to steroid inject the leg, well i questioned this and was told by vets ass that in her notes was.....djd, cannon bone something!!!! and ligament damage.....now as i have said the mare has been left out last night in reasonable sized paddock...i drove up with horsebox and she did the usual buck leap jump around and canter.......hence today i checked all over said leg and still no swelling no heat no pain.
I just dnt get why he would have changed his mind about the xray results and treatment.....maybe had i said she wasnt insured we would just be resting her for a year.

maybe im cynical i dnt know but i dnt want my mare to be given treatment she doesnt need.

i guess ill just have to see wat he says when he comes out tues.

:)
 
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forgot to mention vet also has said we may need to go dwn the route of surgery......seems very quik to decide at min....nt my usual vet i mite ad as they didnt have the facilities to do onsite xray etc, surgery on a leg that was fine now has djd or serious probs all from one xray n ultra sound.....i think iv convinced myself to go for second opinion.
 
Is there any possibility that the vet is looking at the notes for the wrong horse? It sounds too bizarre, this change of advice, and it wouldn't be the first time it has happened. Do either or both of you have common names?
 
brucea said:
I think Imogen will probably wade in here - but I don't think steriods are used as a preventative - ever. That's not their function, and a kind of dangerous thinking route to go down imho.
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lol :D Couldn't resist!

Honestly though this whole case sounds a bit weird.

Wrong notes could be one explanation but never heard of it to this extent before....I'm there's a good explanation :confused:

I think surely the best thing to do is sit down with the case vet and discuss the reasons for your confusion calmly so that they can clarify anything....all sounds a bit odd to me....:rolleyes:
 
well saw vet yesterday and he has looked at injured leg and said he thinks she can come back into work and that it looks like it isnt as serious as he thought!!! when i asked him about the xrays etc and why he put down she had djd and ligament damage on her notes and the injection route he said he is covering all options....the scans showed up nothing but the injury could have caused some damage and we wont know until shes put back into work, he said if shes in work and gets lame again he will give her the injections.

So im kinda happy now that she doesnt need any treatment, altho im still nt convinced iv had a full explanation...but hopefully shell come back into work with no future probs !

ty for all the advice:)
 
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