Thermal Imaging

Darkly_Dreaming_Dex

Darkly_Dreaming_Dex

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Has anyone had it done? We are desperately trying to get to the bottom of a hoof contained lameness,so far we have had two full workups (6 months apart) inc xrays (clear),ultrasound scans (clear) and nerve blocks (came sound on front of hoof/coronet band block). The vet has narrowed it down to the coffin joint area and is treating for arthritis with Adequan & Glucosamine. We want to find out more as there is a 10% chance of being a soft tissue rather than bone issue. The vet feels it is premature to MRI at this stage so thats out of the question so i was surfing and came across this site
http://www.theinnerpicture.com/hoof_problems_lameness.htm
and thought WOW could this give us another view on the problem, afterall it wont do any harm (will it?) Does anyone know of someone who does it in the Thames Valley area?
Thanks x
 
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The vet feels it is premature to MRI at this stage

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Why? He / she has not managed to give you a definitive diagnosis after 6 months so how can that be premature?

For me MRI would be the next logical step.

Thermal imaging does just that, identifies the temperature range. It wont give you a diagnosis so I wouldn't waste any money on it.

If you are desperate to get to the bottom of the problem I would request an immediate referral for MRI, it's ultimately your decision.
 
Also, where has the 10% figure come from?

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We want to find out more as there is a 10% chance of being a soft tissue rather than bone issue.

[/ QUOTE ]

I'm sorry, but it makes me really angry when vets string clients along like this. He/ she (bet it's a he) has got all that money out of you for work ups, x rays, scans (where did he scan ? you can't scan through the hoof capsule) and blocks and clearly still has no idea what the problem is or how to treat it.

Grrrrr.
 
Speaking from past experience, I would get the MRI done if you can afford it or insurance will cover it. There is no other way to be certain. And soft tissue would mean box rest wouldn't it?

While I don't want to go into the details, I wish my vet had suggested it having it done, as I hadn't even heard of it at the time. Now, I'm broke, the insurance was 12 months from onset only, and my only option is box rest with no hope of ever knowing what was wrong, if it is stil wrong, or where I'm going.
 
GeorginaFloppet, sorry to hear your bad experience, I had a similar one, though did get the MRI done within the insurance period, but by then there was much damage done that could have been avoided by earlier diagnosis and less messing about, hence my rather strongly worded post above. I would always go for MRI now if there is any doubt about foot lameness, even if the horse wasnt insured . The standing MRI costs just over £1k and you can easily run that sort of bill up with nerve blocks, x rays and joint injections, and still not have a definitive diagnosis.
 
Rotten experience isn't it. I had a huge excess at the time, so by the time I'd spent that much...!

I just wish I could go back and do it all again, and its only since I've been back at Uni and read up the more recent research work that soft tissue damage even occurred to me. The vets sure as hell didn't even mention it. I suspect there is a lot of damage done in my girl's case as well, but one has to give these things one last shot at working.
 
WE have both asked for a referral- its not for want of trying
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Both vets who have seen our boy do not seem confident in the ability of MRI to give a positive diagnosis. We really want one but without a referral there is no chance of claiming on insurance. If it comes to the crunch then we will find the money but MRI is expensive so it seems unfair not to have a chance on the insurance
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Their independant but shared opinion is that the treatment would be the same (I'm not convinced) whatever is wrong and its such a small chance of being soft tissue/ligament/tendon that it does not justify the cost of MRI
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The reason they think its such a small chance of soft tissue is because the last nerve block at the front of the hoof/coronet band into the coffin joint made him come sound in 5 mins, apparently this indicates a joint problem, if it had taken 10 mins then the longer time for the block to spread would indicate ligament issues.
We use a highly respected practise who do have many diagnostic tools (no MRI though). 6 months ago when he first went lame he had xrays which were clear, they found corns under the shoe, with some attention from the farrier, he came sound so we didnt think it was a big deal (bill was small so didnt claim off insurance). It may well be coincidence its the same leg but he went lame the end of March, he had lost a shoe off this hoof and badly bruised it so again we had no reason to worry until he didnt come sound. The vet is out again on Monday and we will push again for an MRI referral.
Please understand that we are doing everything we can
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Oh don't get me wrong, I didn'e mean to sound like you weren't, I'm quite lucky with my vets in that if I say, "I need horse to go to so-and-so about this or that" they are quite straightforward.

Its really hard to decide as well I suppose, if you took the chance of it being a soft tissue damage, and box rested, then that wouldn't help arthritic or joint conditions perhaps. But we suspect it went the other way for us, in that again x-rays were clear, and we were sent "on our way"... to keep them "on the go" if it is a ligament or something doesn't help either...

Nightmare! Poor ponies.
 
Didn't mean to sound as if having a go either - you are clearly very concerned about your boy and want to do the right thing.

If your vets are reluctant to refer is it worth speaking to your insurance company? I dont know how these things work. I thought vets were obliged to refer if the client requested it. I switched practices once half way through a claim and said I wasnt happy with the treatment my horse was getting and the ins co were ok with it, but things may have changed since then.

The treatment would NOT be the same:arthritis type problems respond to steroid / HA injections and light work . Soft tissue damage needs box rest / controlled exercise. Some foot injuries respond well to shockwave. Glucosamine supplements will help arthritis conditions but are a waste of money if it is soft tissue.

It seems to me your well respected practice are trying to prove that they dont need MRI whereas in fact they have not managed to diagnose your chap. Stamp your feet a bit and get a referral!
 
Please do push for a MRI.
If he comes sound to a coffin joint block and there is nothing to see on xray there is a strong possibility that he has damage to the collateral ligaments of the DIP joint.
If this is the case box rest (for a significant period of time), possibly shock wave treatment and eventually a prolonged re-introduction to walk work is the way forward.
If it is arthritic changes that are causing the lamness then intra-articular medication with steroids and HA is the accepted method of treatment, combined with a controlled exercise programme.
If the DIP joint is medicated 'blind' the horse may well improve / come sound for a short period of time, giving the impression that a return to exercise is indicated. If there is ligamental involvement, as the effect of the steroids wears off the lameness will return because the ligaments will have been being unknowingly put under pressure due to the masking effects of the medication.
So please, please do push for an MRI. You are perfectly within your rights to ask for a second opinion / referral from your current vets. Once your horse is referred, then the referral vet will decide on the correct diagnostics to be employed and should liase with your insurance company on your behalf.
 
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