What is wrong? Options and way forward advice please

Wilbur_Force

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I'll make this short. Horse is lame on off hind. Had nerve blocks and we know that its pastern or lower. Vet out again next week to do the only two nerve blocks left known to man, pastern and coffin joint blocks.

Had X-rays and they're really good. Tiny bit of side bone and tiny spot on coffin joint but vet says nowhere near enough to cause the degree of lameness we're seeing.

Horse is barefoot, always has been. He's 14 years old. Never had a lot of work or been hammered. Always been sound as a bell, so very frustrating at the moment. It'll be 6th vet visit next week and I can feel a trip to Newmarket coming on if we can't pinpoint exact area.

Thoughts please? Thank you
 

Wilbur_Force

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Scanning is my next request. Not been done yet as no heat or swelling and he's positive to flexion.

HH, it was a gradual thing I think, but he's a very stoic horse and would suck it up regardless.

I'm desperate for a diagnosis now, just not fair on him
 

jessieblue

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Is it definitely not in the hoof ie abscess?? I have seen some really bizarre abscesses just recently. Rumbling on causing niggling issues and one popped out on coronet band eventually and one was a "blind" abscess, which had no sign of pus but left a crator in the hoof which the farrier found. Both horses had no real heat in the hoof or digital pulse increase. I guess it may have showed on x ray but depends what part of the hoof the vet x rayed and from what angle. Otherwise I think scans or MRI might be you only chance of being certain. Sorry cant be of more help, but wish you well. I know how worrying these things can be.
 

Holly Hocks

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Is it definitely not in the hoof ie abscess?? I have seen some really bizarre abscesses just recently. Rumbling on causing niggling issues and one popped out on coronet band eventually and one was a "blind" abscess, which had no sign of pus but left a crator in the hoof which the farrier found. Both horses had no real heat in the hoof or digital pulse increase. I guess it may have showed on x ray but depends what part of the hoof the vet x rayed and from what angle. Otherwise I think scans or MRI might be you only chance of being certain. Sorry cant be of more help, but wish you well. I know how worrying these things can be.

This is exactly what I was thinking. My horse had lameness this time last year. Came and went and eventually vet suggested x-rays to see if there were any gas pockets showing which would indicate an abscess. Nothing showed and on that day at the vet she was virtually sound (typical). I had about six vets visits and nerve blocks indicated that it could have been the navicular (already known about) deteriorating. She was booked in for an MRI scan but I was pretty sure it might be an abscess and kept poulticing it. Two days before we were due to go for the MRI scan the abscess burst out. Vet said they had never known one like it - duration was about three months from start to finish.
 

TarrSteps

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I've seen two abscesses that, in retrospect, caused on again, off again lameness for months. Both were very strong, healthy horses with excellent feet and stoic natures - I guess their bodies did a good job of containing and suppressing the infection, which wasn't for the best! Neither had any complications, although I have heard of cases where the infection gets very large and damages structures in the hoof but I would imagine one would see dramatic symptoms by then.

It's not the very first thing I'd think of with a lame horse but, having seen it, I'd never say never.
 

Wilbur_Force

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I have seriously been racking my brains with this one. Initially he seemed lame on both hind legs but he was compensating on the other leg. We've blocked hock, fetlock, tendon sheath, heel bulb, abaxial sesamoid and the low 4 point block. He came up positive to the 4 point block but not to fetlock, hence we're doing pastern and coffin joint. Vet has some pretty vile hoof testers and he's negative to those. Interestingly, when she came out on Fri, he had a slight digital pulse. I'm having I'm tested for cushings too. Would that be connected perhaps? Just throwing a few things out there!

Like I said, X-rays were fab, no problems with laminae or other structure that we could see. I have heard though that cartilage problems don't come up positive to nerve blocks? I'm not ruling anything out at this stage, but I'm so worried because he's so sore, poor lad.

He's still turned out, but in an invalid paddock because he'd have the door off if I box rested him! Each time vet visits though, he's probably a tenth lamer each time.

If only they could talk!
 

Maesfen

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I've recently had a two year old that suddenly appeared to tie up in the paddock, couldn't move a step from 30 minutes earlier when seen hooning around with the others as sound as a pound. That bad we even went up the field with the trailer to bring him in as he couldn't move. Got nearer him and he decides he doesn't like the look of the trailer so staggered a few steps away; while he was actually moving decided to keep him moving so walked him down with lots of stops on the way and OH physically shifting him with a shoulder propped up his backside! Vet was totally flummoxed, never seen anything like it; no marks or heat anywhere, horse looking bright and eating everything in sight of him; couldn't lift any foot up, he was propped solid and couldn't move so he took bloods and was given two bute night and morning for 2 days. Bloods came back as virtually clear, no nasties in system at all just raised muscle enzymes but not enough to be so much of a worry. Bute helped him a small bit but when he moved he was like a laminitic, in fact could move back end far better than front, when he moved his front it was like an up and heave motion rather than actually moving any limbs; vet still flummoxed but suggested physio might be able to delve deeper than he could as horse still could not move well enough to be trailered anywhere for investigative work. Physio came the next morning, while I was tidying him up, he snapped a front leg up a couple of inches and slammed it down hard again and a hole burst in the coronet band! Lots of nice pus oozed out which made him feel a bit easier but still very stilted and laminitic to look at, wouldn't move of his own free will and still no heat in his feet. Physio came and went over him with fine tooth comb, couldn't find anything wrong at all, no hot spots, soft spots, sore spots at all so started grinning and was willing to bet a grand that he had another abscess in the other foot too! Took great delight in ringing vet as I made tea to pull his leg, lol. Farrier out and after a lot of digging and I mean a lot as no clue at all where, he found a pocket of pus. This wasn't as 'mobile' pus as before, more like a thick watery milk. The amount of pain horse was in you would have thought it would be thick and dark but nothing like that at all. Poultice on and horse allowed back out to move again, was sound in walk 2 days later, totally sound and charging about again within a week. Very unusual for a young horse to have one in each foot at same time (only on grass) and to throw up those symptoms with nothing else to account for it.
Basically, what I'm saying is don't give up hope that it's something as simple as an abscess, this vet is top of the tree and it totally stumped him. In his defence, he wouldn't have found the coronet band one at all even if we could have lifted any feet up and the farrier one took some finding as he gave no sign where the pain was and sole ws unmarked.

Good luck, hope it's as simple.
 
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