To Bone SCan or not to bone scan???

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Mearas

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My horse has an undiagnosed lameness probably high up in his hind leg.he has been X rayed which showed nothing obvious so I have 2 options; to bone scan now and have a more accurate diagnosis or to rest him and bring him slowly back into work and see what happens. The complication with this, is if he is still lame I have to make an insurance claim within a year and this may not leave me enough time to truly assess whether he is capable of the work.

He has been turned out an put on a horse walker three times a week for a month and this has improved his lameness greatly

I guess the question is do I have an absolute diagnosis now using an very invasive technique or do I wait an rely on physio, rest, and other alternative solutions and hope all comes right in time?
 
Even if you don't make a claim this time, if you try to claim in the future for a lameness on the same the leg the insurance company won't pay as it will be on the vet record that your horse was lame on that leg.

It is better to get a diagnosis so that your horse can undergo an appropriate treatment plan and so that there will be a specific exclusion (for example the stifle) rather than the whole leg being excluded.

Hope he gets better.
 
I would bone scan, otherwise, even if the lameness goes away, it may recur and you will not be covered insurance wise.

FTW, bone scan is not a 'very invasive technique'.

They have a small injection, that is all.

After which, a camera is placed next to area which is being examined, not even touching, which picks up the radiation. If an area has sustained an injury, inflammation, fracture etc then this shows with a 'hot spot' of increased radioactive uptake therefore pinpointing the area that has been injured.

The horse literally just stands there being held by someone whilst another person moves the camera around to the areas needing imaging, they are sedated in order to keep them still and so they don't spook at the camera but that is all. It is all very relaxed.
 
Thank you JBW I hadn't thought about the aspect of specific exclusion and for your good wishes.

They haven't nerved blocked, Galaxy23, as the vet is pretty sure it is high up eg. sacrioliac region, and apparently neither this or an MRI scan would be helpful.
 
Thanks Tobysg, I understand, what I meant about invasive was the introduction of radiation into his body.

I really appreciate all these opinions as it really helps to clarify my decision.
 
My horse has had the bone scan and it is safe, he was isolated for 48 hours afterwards. It showed up exactly where his issues were and allowed further tests to be done to establish what was wrong. I was nervous but by doing it I found out what was wrong and he has been treated accordingly.
 
If he thinks it's sacro then a bone scan would be helpful. It is a simple procedure (if expensive!)

I had a mare last year with suspected sacro problems which they bone scanned. A small amount of radiation apeared on the bone scan in the sacro so they nerve blocked it to confirm diagnosis. They can nerve block the sacro region, you just need a very specialist vet and hosp to be able to do it.
 
I would bone scan or nerve block. With out a definate answer how can you be sure you are treating correctly. with a full diagnosis you know how to treat, prognosis, likely hood of returning and preventative/managment things with out a diagnosis you dont know these things and your insurance company will put on a broad exclution whne you know the problem they will just exclude that. bone scans are very stright forwards you will probably have nerve blocks to follow up to coinfirm the bone scan results
 
Bone scan. We did and it showed nothing, but at least we have the knowledge that all bone areas are A-ok!

In the end it turned out to be sacro related, but must be in the soft tissue which a bone scan didn't pick up.

At least we have the peace of mind that there is nothing such as kissing spines going on.

I would also suggest calling a few clinics that do the bone scan, I did and saved £400. -I was in the middle of 2.
 
Thanks for all your comments. One thing that is concerning me is that everyone, including the vet is sure it is not bone related, so I imagine it is just to get a better picture of the area???
 
Hiya - I'd def go for the bone scan now rather than later, insurance are so quick to exclude anything! Just had a full lameness work up done on my pony, nerve blocks, xrays and bone scan - showed all sorts but at least i know now. Down side was it showed things i didn't know about and were not causing trouble, now they won't be covered on insurance. My pony spent 2 weeks at the vets in total and doesn't seem affected by it all.
After the bone scan, if there is anything it will highlight areas to look at further, they X rayed mine after the scan to find more - this showed up bony growth indicating arthritis, but i'm not sure what other things they can use if it isn't bone related, i think ultrasound (maybe more for ligaments) and possibly thermography (shows up muscle damage too). A good big practise would help with all kit / options available to use. Good luck!
 
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