To ride or not to ride?

Aragon56

Aragon56

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Hi,

I have a horse that has injured her deep digital flexor tendon on her right fore, and has been on a combination of box and field rest since the summer when she was diagnosed. She actually went lame in March this year but the deep digital flexor was only diagnosed in summer. She hasn't had an mri scan done so I'm not sure how bad the tear is (if it is torn at all), and without this its also hard for the vet to know exactly what the problem is, but the deep digital is the most likely cause. I've had two different opinions from vets about what to do with her and I'm not sure what is for the best.

One vet at her old loan home who came out several times to look at her recommended a short period of box rest followed by several months in the field, which was followed. It did look like she would be ready to come back into work earlier this month, but unfortunately she overdid it in the field and went lame again, and was then prescribed more box rest. During that time she came back to me in Leicester, and we had our vet out. He said that as she had been on rest for so long and it hadn't worked, we may as well put her on bute and start bringing her back into work-as it was best to find out now if it would be an ongoing problem now rather than in six months time when she could potentially still be lame. He also said that if she wasn't lame on the bute then she could be ridden for the rest of her life on it.

Having spoke to her old vet and her loaner they both agreed that the bute was worth a try, but that riding her as well would put extra pressure on her leg-when as little as 8 weeks ago she didn't even want to stand on it apparently. I was worried also that the bute would just mask the pain and make things worse. Having her on bute long term also doesn't sound like an ideal solution to me either. Our vet does come highly recommended and people have been encouraging me to start riding her, but his advice is so different to the previous vet that I haven't yet.

She has been on the bute that he prescribed for the past couple of weeks, and has trotted up sound since. I also got on her for ten minutes and she seemed absolutely fine, which is encouraging. I haven't done anything else as I'm not sure properly riding her is a good idea. So which vet's advice would you follow? If I'm not going to ride her then I may as well wean her off the bute and put her on field rest for the next month or two to let it properly heal. Really quite confused as to what to do, so any opinions would be great-sorry if I have rambled slightly!

Thanks
 
I think there are a number of things to take in to account before you can decide whether to ride on bute or not.
How old is your mare? Why no MRI, is she not insured? What level of work do you want to do with her?
I was in a similar position with my TB, however he had an MRI and was diagnosed with collateral ligament damage (similar to DDFT because it's soft tissue within the foot, although doesn't have quite the same success rate with recovery). He then had steriod injections in to the coffin joint to help reduce associated inflammation, might be worth talking to your vet about trying this. He had three months box rest and nine months paddock rest and was brought back in to work very slowly. We were warned that if it went again that would be it.
He has been intermittently stiff/lame since diagnosis. We tried treating with more rest, silicone gel pads and shockwave therapy. He was never very lame, at most 1/10ths but often not even noticeably to those who didn't know him. However, I wasn't happy so had the vet back out last month. He is now on one danilon every other day and is much happier.
In your case I'd say it depends on how long a period of rest your mare was given. Soft tissue damage in the foot is notoriously slow to heal and most vets advise a year off work. If I were you I'd be unhappy about bringing a lame horse back in to work without a definitive diagnosis. I'd also be wanting a firm diagnosis so I'd know what level of work is suitable in future. I know my boy will never do more than light schooling or hacking as anymore would put the ligament at risk of rupturing.
There is nothing wrong with riding a horse on bute if the vet advises this, however it sounds from what you say that a strict rehab programme might be more beneficial. You say your mare seems fine when ridden but you do realise that you should be walking for anywhere between six weeks and three months before attempting ridden trot work.
Hope there is some helpful advice in there. PM if you want more info.
 
She is 13 at the moment, is insured and petplan have paid for all treatment so far including nerve blocks and radiographic examinations. From the vets report I can see that she was 2/10 lame in June this year. Both vets have mentioned having an mri scan, however the original vet said that it would probably just confirm his presumptive diagnosis of the DDFT, and so the cost of it probably wouldn't be worth it. I also think that at the time my loaner couldn't afford the expense of it. I am going to look into how much of the cost petplan would cover but from what I hear the insurers don't cover much. I would be happy just doing some schooling and hacking with her, it would be fantastic if she was able to jump as well at some point in the future but I'm not going to get my hopes up in case she isn't.

She has had both the coffin joint and navicular bursa blocked already-is this completely different to the steroid injections you mentioned?

So far from the notes I can see that she has had a total of five months paddock rest, and when the 1st vet came out earlier this month he advised another 6 months paddock rest. Like you say he has advised that such injuries usually require a year off work.

I am reassured by the fact that didn't appear to be lame on the one occasion that she has been ridden a few days ago as the 2nd vet warned that if she was lame on bute, she would probably have to be retired, but have heard that some horses can suffer from liver damage amongst other things when on bute long term.

Thanks for your help, its really useful. Hope your TB is making a recovery-are you able to ride him on the danilon or is he still on rest?
 
Bonanza! Petplan cover 100% of MRI, they are the only insurer that do as far as I am aware. You need a vet's referral. If your vet won't refer, get a second opinion from one that will. Only MRI will tell you what you are dealing with. The dent in your vet's fees cover will be around £1000-£1200.
 
I can't help with the costs of a MRI. However without one you will never know for sure what you are dealing with, as brightmount says.
I think you need to go back to your vets and insurers and get one done ASAP!
 
Really?! Thats amazing, I had been told by both vets that most insurers only cover a small percentage. Will be on the phone to petplan tomorrow, I'm sure the vet would be able to refer her.
 
SEIB paid for our MRI, they were very good. Definitely worth talking to the vets and pushing for as without you will never know the degree of damage.
Jesper is no ridden on danilon - he does hacking and some light schooling. He had a total of a year off first though and then six months gentle rehab work.
Yes bute can have long term implications but from my understanding you have to be giving a serious dose for a long time for it to have an impact. My horse is only on one bute every other day so this should not affect him in my vets opinion. Danilon is supposedly better in terms of side effects, etc, so it's also worth talking to your vets about this, but for now push for the MRI, that will help you in deciding whether to rest or ride.
Good luck.
 
I spoke to petplan and they will cover all of the cost, so the next step is to get the vet to refer her. I'm hoping that he will as he did say getting the scan done might be slightly pointless. Did your premium go skyhigh after the insurers paid for the scan?
 
I don't know why your vet would think the MRI pointless, as you have had so much conflicting advice and the horse's prognosis and recovery programme will depend on the extent of the damage. Since you are fortunate to have Petplan insurance I would go for it. In answer to your question, I maxed out my Petplan insurance but haven't noticed anything drastic happening to my premiums. That's why you have insurance after all, to be able to afford the unexpected.

I'm in Kent and was given the choice of Bell Equine (standing MRI) or Newmarket. The vet wanted me to go to Newmarket but the horse is a bad traveller and I wanted to keep her stress to a minimum, especially as she could hardly stand up at that point, so she went to Bell. Does Bristol uni have MRI facilities?
 
I wasn't sure why the last vet thought it was pointless either-to be honest I haven't even met him because I always used to use another vet from the practice, but this one was recommended as having more experience with tendon injuries. I'm sure the vet my loaner used would be able to refer her as a plan b as he was very helpful and has been dealing with Angel a lot longer.

I'm based in Bristol but she's actually kept in Leicester at my aunt's yard (long story but I couldn't afford to keep her down here so my sister looks after her). She's always been a good traveller so wherever she goes to I'm sure she will be fine. She has been put back on field rest for now, I'm just glad that I didn't start bringing her back into work over Xmas, I knew it was too soon.
 
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