Undiagnosed hock pain

[Daniel_Jack]

Also in veterinary but posting here for traffic

My horse has recently been for a lameness assessment having felt a bit off for a couple of weeks - slowing down going down hills, toe dragging.

Local vet and physio identified mild lameness on hinds (2/10).

Thorough lameness work up including nerve blocks, x ray and ultrasound shows horse has mild PSD but this area did not respond to nerve blocking - the only area that did was the hocks but nothing showing on x ray or ultrasound. Vet described lameness as severe which wasn't what I experienced but since we only hack mostly in walk I'm not really pushing her much. Vet advised that as a hock mri is not possible they area should be medicated so both tarsometatarsals were treated with steroids, equilibrium shoes put on all 4 feet (was previously barefoot) and we are now in box rest for a few weeks until laminitis risk passes and walking in hand twice daily.

Prognosis depends on the response to steroids - if lameness has improved then we keep up the rehab, if no improvement vet recommends retirement or perhaps occasional light hack with bute given she's clearly not able to cope with current happy hacker workload.

Interested to see if others have experience of this? Seems odd to me to have non way to diagnose the issue. I've also been reading about psd and had questioned whether or not KS and SI issues should be investigated but vet feels there are no clinical signs point to issues in these areas. I'm tempted to keep pushing if she doesn't improve even if insurance won't cover it as it seems that we have quickly gone from minor lameness to retirement with very little treatment!

 

[Tiddlypom]

Why the extended box rest? It’s usually three days box rest post steroid joint jabs. Or is that for the PSD?

Re SI and KS, do you know of a good chiro vet? That’s who I’d call in next, I think.

 

[Equi]

My lad had undiagnosed fetlock pain again nothing on the xray, no injury and he had no shoes at the time. The vet had him box rest for two days after the injection then he had to be out and gentle walks - I’m not sure why you have to have boxrest for weeks? The laminitis risk is quite low really.
Anyway a few days after the injection he was back to his normal self and has been fine ever since ? but I get a little too up every 7-9months just incase.

personally I think the shoes made a huge difference because they helped him get support where he needed it and then his foot grew back into a better angle for the fetlock.

 

[Daniel_Jack]

Why the extended box rest? It’s usually three days box rest post steroid joint jabs. Or is that for the PSD?

Re SI and KS, do you know of a good chiro vet? That’s who I’d call in next, I think.

It's because of the laminitis risk after the steroid injection. She's out in a hard standing pen for 3 weeks then can go on the grass.

Will look into chiro vets - think there is one relatively nearby so just need vet referral.

 

[Daniel_Jack]

My lad had undiagnosed fetlock pain again nothing on the xray, no injury and he had no shoes at the time. The vet had him box rest for two days after the injection then he had to be out and gentle walks - I’m not sure why you have to have boxrest for weeks? The laminitis risk is quite low really.
Anyway a few days after the injection he was back to his normal self and has been fine ever since ? but I get a little too up every 7-9months just incase.

personally I think the shoes made a huge difference because they helped him get support where he needed it and then his foot grew back into a better angle for the fetlock.

That's really good to know. Vet says 3 weeks for lami risk - I double checked and they were pretty adamant about it and given our grass is coming through again I don't want to go against their advice - much as it would make my life easier!!

 

[Tiddlypom]

Will look into chiro vets - think there is one relatively nearby so just need vet referral.

You can use a chiro vet without referral, as they are qualified vets. If you are insured, though, you may need a referral to get the costs of the chiro vet covered.

I’ve had horses have their joints medicated with steroids several times, and even the Cushing’s mare only has to be kept in for 3 days afterwards...

 

[Daniel_Jack]

You can use a chiro vet without referral, as they are qualified vets. If you are insured, though, you may need a referral to get the costs of the chiro vet covered.

I’ve had horses have their joints medicated with steroids several times, and even the Cushing’s mare only has to be kept in for 3 days afterwards...

Thanks for this. My horse has never to my knowledge had laminitis - she is a fatty though and even with a weight management program (muzzled in field with poor grazing and stabled during the day) she's still on the cusp of being over weight although not sure if that makes a difference. Its been 9 days since the injections so I might give it til the end of the weekend then just turn her out with her muzzle and go back to the old routine as I'd have thought it would be better for her to keep moving.

 

[IrishMilo]

I agree with the others - three weeks seems really excessive on the basis of the steroid risk alone, three days is about normal. My horse with spavin is happiest kept warm, and in very consistent light work.