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Discussion on Swollen knee

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David North
New Member
Username: Dnorth

Post Number: 1
Registered: 3-2005
Posted on Wednesday, Jun 1, 2005 - 5:44 pm:   Edit PostPrint Post

In the first ride after a week off, KoKo (our 11 year old quarter horse mare), stumble a few time, but I didn't think much of it. Then she refused to turn at a lope (which I am trying to break her of) and about ran into the side of the area, started bucking, and off I went. Got back on and then she stumbled to her knees. Got of to check her out an noticed that her front left knee was swollen.

Treated it for 5 day with running cold water and menthol linament. Not much change in the swelling. After 2 days put her in the round pen and noticed her stubling twice during a very short session (10 min) Usually she is in a paddock with other horses but we left her in the stall the last day (5).

Took her to the vet and in his exam found no lameness, took x-rays and found no bone chips or any other issues. His diagnosis was bursitis and said the swelling (which is slight) might not go away. Recommended return to activity and to treat for 30 days with ointment containing DMSO. He didn't think the brusitis necessarily caused the stubling.

So we plan to start working her again and using the ointment.

Does this sound like a good plan? Any input is welcome.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 13008
Registered: 1-1997
Posted on Thursday, Jun 2, 2005 - 8:46 am:   Edit PostPrint Post

Hello David,
Since there are no bursa in the front of the knee that I am aware of which bursa does he think is inflammed David?

Concerning your initial treatment, menthol is not an antiinflammatory in fact just the opposite, better would have been bute and pressure bandaging. I do like the cold water if done for at least 20 minutes however. This is not just important for what you can see but the trauma to the joint capsules cause intrarticular inflammation that can result in arthritis, effective antiinflammatory may prevent this. The DMSO is OK but doesn't replace the earlier recommendations.
DrO
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Bob Stack R.Ph.
Member
Username: Bobs

Post Number: 20
Registered: 4-2005
Posted on Thursday, Jun 2, 2005 - 11:43 am:   Edit PostPrint Post

Dear Dr. O
Have you tried any of the transdermal NSAID. We use them in humans with good success. High dose where you need it and only about 2% total body exposure. We use ketoprfen alot but phenylbutazone would lend itself to topical administration. Please consider this if nsaids are causing problems
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Bob Stack R.Ph.
Member
Username: Bobs

Post Number: 21
Registered: 4-2005
Posted on Thursday, Jun 2, 2005 - 11:47 am:   Edit PostPrint Post

I can not recommend the metnhol ointment or DMSO for the swollen knee. They may relive the pain but will not touch the inflammation. For humans rest, ice, and NSAID(phenylbutazone for horses) would be a standard recomendation
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Susan Bilsky
Member
Username: Suzeb

Post Number: 394
Registered: 8-2002
Posted on Thursday, Jun 2, 2005 - 2:49 pm:   Edit PostPrint Post

Bob,
There have been discussions on a topical called Surpass. Run a search and see what you think.

Susan B.
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David North
New Member
Username: Dnorth

Post Number: 2
Registered: 3-2005
Posted on Thursday, Jun 2, 2005 - 3:06 pm:   Edit PostPrint Post

Dr.O.

Thanks for the input. This is our first horse and I get a lot of advise around the stable on what to do. Most of it conflicting.

The vets explaination was that there was a bursa in the knee. I had read about carpal hygroma so I was guessing that is what he was talking about. The description I read match what he describe. So I guess I will check again with him on that for more specifics.

I certainly want to be on a treatment plan that has some chance of success. I understand about using some anti-imflamitory.

Do you recommend rest and minimal activity until the swelling goes down or a return to normal activity before that occours?
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Bob Stack R.Ph.
Member
Username: Bobs

Post Number: 22
Registered: 4-2005
Posted on Thursday, Jun 2, 2005 - 4:23 pm:   Edit PostPrint Post

Yes, Surpass and other NSAID(phenylbutazone) transdermally are safe. You do not dose the whole animal, just the part you need.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 13024
Registered: 1-1997
Posted on Friday, Jun 3, 2005 - 7:53 am:   Edit PostPrint Post

Hygromas, are a bit of a oddity brought about from chronic trauma that grow over time, where the body actually forms a bursa, a synovial lined cavity not associated with a tendon or joint, where there was not one before. This is not something that pops up from a one time fall at least not until several months go by and pretty rare. It would be considered a complication of poor healing.

The answer to your question depends on the nature of the swelling. Assuming the horse shows no lameness and the radiographs good: If this is just some sub-q edema and the joint capsules not swollen I would say light work would be OK and once the swelling gone full work. If the joint capsules are swollen, I would certainly wait until I was sure all the inflammation was out and control the amount of exercise the horse gets by stalling and hand walking or perhaps a small paddock. If I did not know I would recommend the more conservative approach, just in case.
DrO
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 13032
Registered: 1-1997
Posted on Friday, Jun 3, 2005 - 12:57 pm:   Edit PostPrint Post

Bob I just caught your question from above on Surpass. We have found noticable improvement following it use on a hock and mild improvement on a stifle (a nonlabel use it should be noted), both with osteoarthritis, but it did not improve as much as with 1 gram of bute twice daily.
DrO
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