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View Full Version : As if anything else couldn't go wrong....navicular?



alsxx
15-02-09, 02:47 PM
As some of you may have read, I have had rather a lot of bad luck in the last 6 months with my 5 1/2 year old mare. She was assessed end of Jan and found to be sound - great I thought!! She had to go to the RVC on Monday for the insurance co who wanted an independant opinion. I honestly thought they wouldn't find anything wrong with her, however I noticed a few days before she went that she had started resting her left hind quite a lot (which was the one she had hurt her tendon sheath) and that the sheath was a little up/down and slightly warm, so started to dread our visit.

So off we went, and on initial trot up she looked fab, although they noticed she was 1/10 lame on RF - not that I could see it. On lunge on soft she looked great on the left rein, she was really elevated and her stride length was great. Cue other rein and slightly lame, back to left rain and LH started to get shorter and shorter. Needless to say on the lunge on the hard she looked cr*p RF and LH. http://www.horseandhound.co.uk/forums/images/graemlins/mad.gif http://www.horseandhound.co.uk/forums/images/graemlins/confused.gif http://www.horseandhound.co.uk/forums/images/graemlins/frown.gif

So she ended up staying in for yet another workup (her 3rd in 6months), and at the moment I don't really know what they have found as I am still waiting a bl**dy phone call from the vet, even though she came home yesterday.

All I know is that it is the LH tendon sheath again - ??????

And that she partially blocked to the navicular bursa in the RF, and I *think* partial to the coffin joint too. They were x-raying on fri to see if there were any changes - i have no idea if there were at the moment, or what they suspect as no one has had the courtesy to call me!!!!!!! So, I am dreading navicular disease... but could it be this, or something else???

AND, does anyone have any ideas as to how my little mare who I have taken things really slowly and carefully with, has ended up with arthritis in both hocks (although no sign of spavin yet according to RVC which is good) and front fetlocks, does a LH tendon sheath and now looks like has something else going on in her RF foot???? By the age of 5 1/2?????? Vet found her feet were unbalanced - and has been corrected....but they were not horrendously bad, could this have contributed to all of this????

So next step I think is MRI...... http://www.horseandhound.co.uk/forums/images/graemlins/frown.gif

Sorry it was long!

teddyt
15-02-09, 03:08 PM
Poor you, what a nightmare. Unfortunately, even young horses can have arthritis and navicular. There is a strong genetic predisposition to navicular, to do with the shape of the bone and the blood supply to it. Hence why you shouldnt breed from a horse with navicular.
Arthritis can start if the foot balance has been bad due to the extra strain it puts on the joints. Poor conformation or weaknesses also contributes, e.g. pidgeon toes.
Lameness in diagonal limbs is common due to compensation.
Just try to stay positive as good management is half the battle with problems like these. A good joint supplement, careful exercise, turnout, keeping weight down, good farriery, etc all go a long way to helping.

lirago
15-02-09, 03:10 PM
All I will say is dont think this is the end I have similar problems with my six year old mare who I have taken things slowly with. She has high ring bone on her NF and arthritic changes in her coffin joint same leg its taken a while to get a diagnosis but vets are confident with the correct shoeing (her foot balance in that leg is off due to the way she wait bares) she wills stay sound. I have been using bioflow boots at night while she is stabled and these seemed to have help settle down the inflamation around the ringbone she is now sound all we can do is wait. dont give up I have had loads of advice from people with similar probs and they have had happy sound horses for many years with the right management.
your not on your own its just fustrating all the waiting!

alsxx
15-02-09, 03:28 PM
Thanks both for replies, I think the worse thing is waiting to see where to go next. My own vet is very positive (I go from positive to negative and back again a few times!!), and to be fair she has had both front fetlocks and both hocks treated and *touches wood* these are fine - the RVC couldn't find anything wrong with those. They also loved her feet, and said gold star to the farrier!

Its irritating that she has done the tendon sheath again (and today it was the most swollen it has ever been, so I really want to know what they are advising so my vet can treat it accordingly), I dont think anything showed up on the ultrasound they did (they scanned pretty much hock down to fetlock on both hinds) - but again I don't know for sure!!

Its just the right fore that is really worrying me, probably the not knowing more than anything.

Poor little mare though, she is very chirpy and happy to be fair, although bored of box rest. Today she was in the spare stable whilst I mucked her out and she actually went rumaging under the rubber matting...pulling it up with her teeth!

lirago
15-02-09, 03:32 PM
bless her storm spent 12 weeks on box rest i used to hide carrots for her to find and got her a stable mirror she didnt like being on her own she still spends hours looking in it shes so vain but it help with her boredom. hope you find out whats happening soon think its more fustrating for us than it is for them

Marchtime
15-02-09, 06:30 PM
alsxx I'm so sorry to hear. Don't blame yourself. My 10 yr old TB who I've had since 4yrs old was retired this week due to left hind suspensory and right fore collateral ligament damage. Similar to yours he did his left hind suspensory damage as a 4yr old then at 8yrs old went for an MRI after nerve blocks confirmed it was the coffin joint but x-rays were clear. Sadly the combination of diagonal pair injury meant he never recovered and his left hind has flared back up. I hope yours has a happier ending but at least you know you haven't done anything to cause it. If your x-rays come back clear push for an MRI as an early diagnosis can make all the difference. Good luck.

Halfstep
15-02-09, 06:50 PM
What a nightmare. Unfortunately it looks like this work up has opened up a can of worms which perhaps otherwise would have remained in the dark for a long time.

I do think that in cases like this, one wonders whether if the vets/insurance company didn't go looking so closely, no one would be the wiser and the horse and owner would continue as normal.

But, once problems are found you know they are there, so you at least are one step closer to solving them.

You say the vets found signs of arthritis in both hocks, ok, so what have they done about this? Not hugely unusual for a young horse to show arthritic changes on x-ray which are non-symptomatic yet. The tendon sheath problem is different - these are tricky and can flare up again. If the horse has had a hind limb lameness this can cause an imbalance in the way it carries itself, often triggering or exacerbating problems in front.

Remember that Navicular is a scary word that covers a huge spectrum of problems, many of which are manageable. Nerve blocking is far from an exact science, so who knows what will show in the MRI.

I have to say, experiences like this make me ponder the influence of insurance companies on veterinary medicine and whether it always is to the benefit of the horse and owner.

Anyway, fingers crossed for you and your horse.

alsxx
15-02-09, 07:32 PM
Halfstep, how right you are re the insurance....because of their involvement things have been over complicated and the poor mare has been subjected to workup after workup. I honestly find myself wondering what their priority is, as it certainly isn't the welfare of the animal as far as I'm concerned!!!

Re her hocks, she has had these treated with steroid injections, and successfully, as have the front fetlocks (touches wood!). Her tendon sheath was treated in a similar fashion, however she hasn't been the best on box rest, and can execute quite an array of bucks and rears and spins in her 12x12 and so I would guess that it is why it has flared up again.

Its certainly frustrating as she was found to be sound on the 22nd Jan; and she has been quite a prat since then (particulary after she had physio and was on a course of anti-inflammatories for 10 days afterwards). She also developed an abscess about 4 weeks ago and did not react to hoof testers on the Rf then, or 2 weeks ago when I thought she had it back again. Then at the RVC on Monday, she did react to the heel of the Rf. But how much of that is an unfit, unmuscled horse being trotted and lunged on the hard for the best part of 45 minutes?

So I'm sure the next step is MRI (vet that discharged her mentioned MRI'ing all 3 legs bar the RH???). I dont even have her insured for l.o.u as she would simply be retired to my parents and she simply isn't worth that much - so why on earth they are digging around so much I don't know.

Actually I think I do - its because they have an issue with my vet http://www.horseandhound.co.uk/forums/images/graemlins/smirk.gif

jenh166
15-02-09, 07:54 PM
They're just doing their job...if you don't want them to investigate any further then it's up to you to tell them. And if the insurance had requested it, then it's not the vet's fault. Having said that, not telling you what they've found yet is a bit off...you should ring again first thing tomorrow and demand to speak to the vet in charge.

Butterbean
15-02-09, 08:53 PM
What a nightmare, my horse is the same, he is 8 this year but hasn't been right for about 15 months now, had 2 major surgeries last year for different conditions, just got him home and now he has torn a tendon. Some horses are just accident prone / injury prone / disease prone even if you look after them and try to do the best for them all the time.

neddynesbitt
15-02-09, 10:55 PM
I have had a very similar situation to you. We had owned our lad for a year and my daughter was doing so well with him. They had been on the PC SJ and eventing teams, done PC camp etc when he suddenly became unsound. I couldn't make up my mind which leg he was lame on so got my YO to take a look and she couldn't decide either. One minute we thought it was LH then we thought it was RF. He was resting his LH a lot so we thought it must be behind.

When the vet came, she was pretty sure it was LH and said he would need to go in for a work out. To add to our problems he has a severe needle phobia!!

At lunchtime, the vet called and I was gobsmacked when she said he was sound behind but they had xrayed his hocks and they were fine. She too said he had blocked out on his RF and she was sure it was in his foot.

The next step was to go down to Bell Equine for his MRI (I must warn you that the results for MRI unless mega obvious take around a week)

Sadly, he does have navicular. Everyone is gobsmacked as if you look at his feet they look really good and not boxy or unbalanced in the slightest. My farrier is convinced that he had stood on a huge stone and badly bruised his sole which can take some time to heal. He feels that if my lad hadn't done this and we had the MRI done, we probably wouldn't have known for around another 5 or 6 years!!

My insurance will pay for a physio and although I have always been very sceptical about them, she has done wonders with him.

He has had 1 Tildren drip 2 months ago and is going back in on Weds for another (again, I must warn you the cost for 1 drip is 1k)

I have spoken to lots of people who say that navicular needn't be the end of them (I hope not we are not insured for LOU either) I do know of a horse competing at Int Horse trials with it so I am keeping my fingers crossed for our lad and for you.

He had no symptoms prior to going lame but, he was always very strong and my daughters instructor from camp said looking back now it could well be that he was feeling his feet then and reacted by running from the pain. There is a strong possibility of this but I am still confused that if he was in pain, why did he NEVER stop when jumping??

Good luck and please keep us updated. Will you be going to Bells as well??

alsxx
16-02-09, 10:06 AM
Bean - I had told them I didn't want her to go the RVC for another workup, however as its the insurance who have requested it, they kind of had me over a barrell as they wouldn't pay any more invoices until she had been. Essentially, they have repeated everything my vet had already done, just for the purpose of satisfying the insurance company.

neddynesbitt - I am really really hoping its not 'navicular disease' - It could be any manner of things as she only partially blocked to that region. I know there are lot of things that can be done. Not sure where she will be going yet...vet usually refers to Cambridge. I'm sat here scratching my head though like you probably are - I am wondering how on earth she was sound one day, and lame the next, and how so many things have gone wrong in the space of 6 months.

millimoo
16-02-09, 10:45 AM
We had a young horse the same age with low grade lameness.
Nerve blocks revealed problem in the foot.
X-Rays were clear, but MRI scan revealed an old tendon injury in the foot which had destabilised the joint causing arthritis.
MRI scans show up an awful lot more than X-Rays and scans, however are costly and not always covered by insurance.
For us, we probably saved a lot of time of unnecessary box rest etc and got to the bottom of the problem straight away.

alsxx
16-02-09, 02:36 PM
UPDATE

Although I have still received no call, the report has gone to the insurers who are sending it across to me now. Apparantly they suspect the deep digital flexor tendon. MRI is next step on 3 legs. http://www.horseandhound.co.uk/forums/images/graemlins/frown.gif

hussar
16-02-09, 03:35 PM
[ QUOTE ]
UPDATE

Although I have still received no call, the report has gone to the insurers who are sending it across to me now. Apparantly they suspect the deep digital flexor tendon. MRI is next step on 3 legs. http://www.horseandhound.co.uk/forums/images/graemlins/frown.gif

[/ QUOTE ]

If it is DDFT, take heart - there's a small but select group of us on here all with DDFT injuries at different stages of rehab and most of us seem to have more cause to be hopeful than not. Search DDFT and you'll find several recent threads.

Good luck!