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lwitz
New Member
Username: lwitz
Post Number: 1
Registered: 7-2008
| | Posted on Tuesday, Aug 18, 2009 - 6:12 pm: |   |
Hello Dr: my 15 yr old arabian show horse who has been showing since he was 3, saddle-seat- english pleasure and then country pleasure, showhack and sidesaddle has been lame since March. In pre-purchase exam, arthritic joints were identified but not lame. I believe an event took place in March that caused a swelling from fetlock down to hoof, front leg, and , and off,heat in hoof.
Stall rest and IRAP (3 tx) were just completed.
He is better but still off. Only exrays were done to identify arthritis. When asked about arthroscopy I was told it would not do anything?
It is hard to believe that my buddy is no longer able to be ridden? Suggestion was give him 6 months off and revisit.
If it were just arthritis, how would it have gotten better. I want to believe there is hope and if he strained, tore and damaged a ligament, suspensory, etc, we would not have seen that on the exray. His arthritis has been there, maybe there has been a tear and the time is needed to heal. Should I have him ultrasounded?He was blocked and at first the doctor thought it was in the hoof. He did not go 100% sound with the blocks?Looking for hope. |
Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 23597
Registered: 1-1997
| | Posted on Wednesday, Aug 19, 2009 - 12:19 am: | |
Welcome lovitz,
I agree the history of generalized swelling and heat from the fetlock down is not consistent with arthritis but other injury to the lower leg could activate degenerative joint disease. Acute exacerbations of arthritis do get better with rest but so do many injuries so it is not much to hang a diagnosis on. I would also note that some of the soft tissue injuries you list do not always have a good prognosis associated with them. To answer your other direct questions and whether your general hope that the prognosis is better will first require a good diagnosis that you have confidence in and then exploring all the therapeutic options. So let me ask a few questions starting with:
1) Which joint has been diagnosed with arthritis?
2) Which blocks were done and what were the results?
DrO |
lwitz
New Member
Username: lwitz
Post Number: 2
Registered: 7-2008
| | Posted on Thursday, Aug 20, 2009 - 5:07 pm: | |
the fetlock front right, 3 blocks were performed, starting at lowest area, the soundness was not improved till last block, higher up the leg but still not 100%, slightly better. Another interesting point is my farrier pointed out that on this foot the hairline is not straight across, the coronary band , hairline dips downward and then back up. He thought that this might be a part of discomfort if the hoof capsule has been changed due to irregular hairline. The farrier is going to place barshoes on and pack the shoe with that equipac to give more support and roll the toe.
I would also like to try the cox 2 inhibitor, furocoxib? to see if that helps with pain? |
Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 23615
Registered: 1-1997
| | Posted on Friday, Aug 21, 2009 - 2:58 am: | |
Thanks lwithz,
The positive way to identify the fetlock joint as a source of pain would be a straight forward fetlock joint block, it along with concurring radiography, would raise the confidence level of the diagnosis up to close to 90%.
As to the treatment of arthritis I would suggest you look at the whole treatment plan in a holistic manner, for more on this including the use of firoxocib in arthritis see, Diseases of Horses » Lameness » Joint, Bone, Ligament Diseases » Arthritis and DJD: An Overview. For more on firocoxib in particular check out Treatments and Medications for Horses » Anti-inflammatories (NSAID's, Steroids, Arthritis Rx) » EQUIOXX (firocoxib).
DrO |
