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Discussion on Swelling to hock

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S. T. Bruce
Member
Username: Kari

Post Number: 201
Registered: 3-2000
Posted on Monday, Jun 13, 2005 - 10:42 pm:   Edit PostPrint Post

Dr. O

On the A.M. of 5/22/05 I observed a large swelling on the left front knee of my 13 mo. old filly. The swelling was approx. the size of a large grapefruit bulging to the front and outside portion of the knee. The filly did not then or now show any lameness. The swelling was soft and upon squeezing it, the filly did not indicate any discomfort. Some minor scratches around the swelling has led me to believe that she caught the knee in the american wire fence surrounding the pasture she shares with two other yearlings and a two year old.

I gave her one gram of bute (she is approx. 625 to 675lbs) and did 20 minutes of hosing. I repeated the bute and hosing that evening.

On the next morning the swelling had not reduced so I called my local vet and she oked the bute and hosing and recommended applying DSMO to the swelling twice a day.

I followed this routine for approx. 9 days with no appreciable reduction in the swelling. Since my local vet does not have radiographs or ultra-sound she suggested going to another vet for these services.

On June 6, 05 I took her to another vet who made three radiographs to the carpus region. He found no bony lesions and diagnosed "capsulitis - 2o to synovial fluid production as a result of trauma". He drained approx. 30-40 ml from the joint but felt some debris was blocking further drainage.

The vet injected 10cc of Dexmethasone into the joint and instructed me to repeat the same dose IM on Wed. and Fri. of the same week. I was also to continue the hydrotherapy and return in 10 days. I was to discontinue the bute and DSMO.

It is now approx. one week since the last procedure and the swelling is approx. the same size.

I have used this vet before and have no problems with him however I have these questions.

(1.) Are there other avenues to use to determine why the swelling continues and if he recommends the continued conservative treatment, should I seek other professional opinions.

(2.) Under the time frame (5/22/05 to 6/l3/05) is more damage being done by the continual presence of the swelling so that other prompt treatment should be sought. I'm not looking to sue anybody, just want to get the issue resolved for the filly's benefit and mine.

The filly is in a 2 to 3 acre pasture and roams freely with her other companions.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 13138
Registered: 1-1997
Posted on Tuesday, Jun 14, 2005 - 5:29 pm:   Edit PostPrint Post

An acute swelling of that size does not strike me to be an enlargement of the carpal joint capsules (I would have called it a synovitis). However it is hard to argue with someone who has examined the horse. Although this could have been a seroma in front of the joint capsules. Also a ruptured extensor tendon insertion may cause such a swelling though usually other signs are present as well. An ultrasound might better define the swelling.

Pressure bandaging should be used to help reduce this swelling along with antiinflammatories. The tissues may have lost some of there elasticity and certainly the pressure is more than the tissue can contain. While on dex the bute may not be needed but should be started 48hrs after the dex is stopped. If you continue to be uncomfortable with this vets recommendations, yes do seek a second opinion.
DrO
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S. T. Bruce
Member
Username: Kari

Post Number: 202
Registered: 3-2000
Posted on Thursday, Jun 16, 2005 - 10:43 pm:   Edit PostPrint Post

Dr. O,

Returned to the vet this P.M. An ultra sound exam revealed "multiple hypoechoic areas in extensive tendon". No actual tears were seen.
He injected the area with HA,DM and advised me to continue hydrotherapy and return in two weeks.

He did not want to pressure wrap being concerned of the swelling. He also advised not to administer Bute unless sore.

As am trial attorney for over 35 years I never like second guessing another attorney's trial decisions and from your post I suspect you feel the same way. That said, do you have any further suggestions other than those given before.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 13162
Registered: 1-1997
Posted on Friday, Jun 17, 2005 - 9:28 am:   Edit PostPrint Post

ST would it be possible to get some pictures or the swelling? At least 2 views one from the side and the front and take care to have the lighting behind you or better use a flash.
DrO
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S. T. Bruce
Member
Username: Kari

Post Number: 204
Registered: 3-2000
Posted on Wednesday, Jun 22, 2005 - 10:29 pm:   Edit PostPrint Post

Dr. O,

Apparently my last post did not go thru. I am unable to furnish any pictures for the foreseeable future.

Since the ultrasound showed inflammation in the extensor(I previously called it an extensive) tendon, would it be futile to start administrating bute again? I don't like to second guess my vet but he is almost two hrs. away and the swelling, while reduced somewhat, is still present.
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S. T. Bruce
Member
Username: Kari

Post Number: 205
Registered: 3-2000
Posted on Sunday, Jun 26, 2005 - 10:45 pm:   Edit PostPrint Post

Dr. O,

I've not heard from you since my June 22nd. post but have started bute (lgram @2 times per day along with 20 minutes of hosing @2 times per day. The swelling has reduced to the size of a orange but has become quite firm.

I'm to return to the vet this Thurs. My concern is with the firmness of the swelling. Is this indicative that the swelling may never go away or is there other procedures that can be instituted at this time?

The filly is not lame and does not show any discomfort when the swelling is squeezed.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 13236
Registered: 1-1997
Posted on Monday, Jun 27, 2005 - 7:15 am:   Edit PostPrint Post

Hello ST,
I posted but apparently it was lost in cyberspace. I had suggested that you try the bute and pressure bandaging if OK'ed by your vet. Now that it has hardened I am not sure if this is indicated but the problem comes with the adjective firm, one person's firm may be another one's fluid filled. If the fluid has coagulated it could be removed with surgery.
DrO
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Ashley Metcalf
New Member
Username: Ashl

Post Number: 2
Registered: 2-2006
Posted on Monday, Feb 13, 2006 - 12:50 am:   Edit PostPrint Post

Hey all,
I'm pretty new to this site so I don't know how it works really, so excuse me if I am interrupting anyone, but I am recently President of Baylor Riding Association, and our horses have been having problems with their backs and legs which I had suspicions that was due to their hocks. i think this because whenever I felt their legs, particularly their ankles, they are extremely sore and kick.
Now, I've already gotten the Hocks injected on the horses, and am now told by a certain member that Hocks injections are bad and inhumane for horses???? and if the problems weren't their hocks to begin with, it could lead to fatal consequences in the future? Is there any truth to this? I am new at Equine Care as well, thus me joining this site to gain knowledge, please enlighten me. Thanks!
Ashley at Baylor U!
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 14783
Registered: 1-1997
Posted on Monday, Feb 13, 2006 - 7:34 am:   Edit PostPrint Post

You have several issues in your post Ashley that are each handled in the article Equine Diseases » Lameness » Joint & Bone Diseases » Arthritis and DJD: An Overview. You will read about how to diagnose arthritis and about treatment. No injecting hocks is none of the above but should not be done if there is no disease there so proper diagnosis is important.

You have interrupted someone else's discussion Ashley. When you go to the above referenced article you will find under it's window a list of discussions and at the bottom a Start A New Discussion button that allows you to begin your own discussion.
DrO
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