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New Member:
mysi

Posted on Monday, Jan 22, 2007 - 1:58 pm:

I hope I can get some advice.

On December 1st my 14yr old 17.1 hand warmblood/draft cross were out trail riding and he spooked and backed up into a seemingly grassy shallow ditch (about 3ft lower)on the side of the road. He did not slip nor was there any trauma going into it. Once in the ditch, we sank in muck up to his belly. I got off and encouraged him to get out by pulling his reins. He pulled his upper body out and got his feet on the side of the ditch. I pulled again and he collapsed onto his knees. I let him rest for a few minutes as he was exhausted and once he started eating grass in the ditch I thought he was ready. I gave him one last pull and and he pulled himself out.

I hand walked him back to the barn (about 100yards). He was obviously sore the next day but seemed fine otherwise. As a precaution I had my vet come out 3 days afterwards. He traveled base wide at the walk and showed no pain, heat or swelling or discomfort to his shoulders. He had a grade 1 mild lameness on staightline trot on the Right Front and mild grade 1 lameness to left lounge trot. Right circle no lameness. She did a full flex test on him and he had no lower extremities showing lameness. She said to give him a week off and start light work (walk/trot) for a week and progress from there.

I did that, he's was good, a little stiff at first but worked out of it, but just not right yet. My farrier came out December 15th and reshod him. He is an experienced horsemen and I wanted his opinion. We trotted him on hard and soft surfaces and he said it was his right front and was so minor and he suggested to have a massage therapist see him that it was likely muscular and my vet agreed.

On January 7th I had a massage therapist come out. She noted alot of discomfort in his right shoulder, and glute muscles. She suggested along with the vet to have a chiropractor adjust him. They told me to continue to work him at the walk and trot in long straight lines.

I did that everyday and the following week January 13th the chiropractor(who is also a vet) came out. He looked him over, had me trot him on hard and soft surfaces and he was only slightly off in the right front, -1 grade on hard and 1 on soft. He flexed him everywhere and he showed no sensitivity to it at all. He adjusted him and noted adjustments to right shoulder and sacral base posterior. Upon examination he noticed "significant synovial effusion in the right hind stifle" and recommended xrays of the stifle.

Here's my dilemma: everyone feels his front right is where he is off. Now, due to swelling in the stifle (which feels life a stiff muscle on his inner thigh - that is only there when he stands a certain way) all they are focussed on is the taking x-rays of the stifles. Which I'm okay with, but I don't feel is the issue with his lameness. Instictively, I feel the stifle swelling is strain from carrying his weight in his hind end to compensate for his discomfort on the front. (I could be wrong though). I'm sure he has arthritis due to his age and size, but he has never taken a lame step. I'm concerned also because they are already saying I should inject his stifles and I don't want to do that if that is not where the problem really is.

He does not favor a side when standing, doesn't seem uncomfortable AT ALL except a slight head bob front the right front. He behaves exactly the same.

Prior to all of this he was VERY fit, worked 6 days a week, walk trot, canter, etc. We jump ( max 3ft ) once a week. Even the vet's said he looks like he's 6-8 physically.

I'm only concerned that are missing something, or I'm not asking the right things, or that I should be doing something more or less. Should I ask them to look for something else? I just want him to be okay and don't want to keep delaying looking for the true problem.
Moderator:
DrO

Posted on Tuesday, Jan 23, 2007 - 6:24 am:

Welcome Melissa,
I can understand your reluctance to spend a lot of time pursuing a hindlimb swelling when you and everyone else believes it is the front that is lame.

Acute remarkable synovial swelling in the stifle is nothing to ignore however. Note well: the swelling would not be from compensatory weight bearing from lameness in the front. It is not that uncommon to get a head bob with a rear end lameness, but usually you can see the rear end lameness also. What if everyone is missing the harder to see hip bob? Interestingly a hind limb lameness that acts this way causes a head bob that will dependably looks like ipsilateral (the same side) lameness, as in your case.

In either case however careful use of nerve and intraarticular blocks will define the location better (see the article Localizing Lameness for more on this). Whether you start with the stifle or the front limb does not matter but radiographs are unlikely to be fruitful since this is likely soft tissue strain. If it does localize to the stifle however the radiographs will be mandatory, just to be sure. You can find more on stifle lameness diagnosis elsewhere here once it localizes there.
DrO
New Member:
mysi

Posted on Tuesday, Jan 23, 2007 - 7:35 am:

Thank you Dr. O for your response it was very helpful. I'm not sure why the vet doesn't think my horse needs to be blocked to find the problem, I guess that's why I'm worried they may be overlooking something. She is actually coming out to xray him today because they made it seem urgent. Should I have an ultrasound done? Or is there a better way to detect a soft tissue strain? I will definitely ask her to localize the problem before pursuing further. I just hate this lengthy process. My horse is the love of my life (next to my husband of course) and I hate to make him go through all of this. I am also greatly concerned that they have me working him daily as I worry I could be doing more damage considering we are not sure what is wrong.
Moderator:
DrO

Posted on Wednesday, Jan 24, 2007 - 6:23 am:

I would let the exam direct the appropriate follow up imaging as explained in the article referenced above. I agree that diagnostic anesthesia could help answer your questions.
DrO
New Member:
mysi

Posted on Saturday, Jan 27, 2007 - 10:40 pm:

Well, I guess there's a reason I'm not a vet! :-)
My vet came on Tuesday along with the chiropractor. I had so many questions and concerns so we sat down and discussed everything I was worried about and they answered all of my questions.

They trotted my horse, lounged him, flexed him again and etc. He actually looked completely sound to me. That would be because I cannot see his hind end being off. So they had my trainer get on him and trot him around as they pointed out his "dragging" hind end. I still didn't see it. Then they had her canter him and OH MY GOD! I definitely saw it then. It was like he was struggling to move it along. It was literally dragging behind him.

His front end looked great. The chiropractor explained that his shoulder was out of alignment when he adjusted him but that it's fine now. I would agree. I hadn't lounged him since he was adjusted, but when I rode him it felt like the front.

So, my vet blocked his stifle and trotted him. He looked fine, but I didn't notice it at the trot before. They said he looked sound and so we radiographed his stifles. He had significant arthritic changes, more so on his right stifle where they felt he was lame. They said that was likely what has caused him to become lame and that the incident with the ditch likely caused trauma to the area. She said that they could inject him with Legend and steroids, followed by a series of adequan and that would most likely improve his movement. They explained if it didn't help it could be soft tissue damage and we would go form there if that is the case.

I agreed and we injected him on Thursday. She explained that he would be on stall rest for three days, that I could hand walk him which I've done. He seems good, but he was sound at the walk anyway. I can get on his back and walk him Sunday (tomorrow). Then I start light work for 6 days and then she will be back to evaluate his progress. She said that the Legend works right away but the steroid takes several days to kick in. I started the Adequan today too. I have my fingers crossed.

How effective is injecting stifles? I can't seem to find out much about it. I know it's pretty helpful in hocks. I'm kind of scared I'm going to break him now, like he's fragile or something. Can he really be back to normal after this? Would it be beneficial to keep him on Adequan? I already have him on an oral supplement - HylaSport. It has 10,000mg Glucosamine, 10,000mg MSM, 2000mg ChonDrOtin Sulfate, 100 mg Hyaluronic Acid and 4500mg Vitamin C.
Moderator:
DrO

Posted on Sunday, Jan 28, 2007 - 7:55 am:

The chiropractors comment that the shoulder is "out of alignment" has no medical meaning that I can ascertain, and neither is there anything you can put back into alignment with manual adjustment. Let us just call this "deep massage".

Concerning the stifles, the prognosis depends on what the predisposing factors are and how advanced the DJD. What does the vet who has seen your horses radiographs say?

You can read more about treatments starting with the article on DJD, following the links to the article on specific therapies.
DrO
New Member:
mysi

Posted on Sunday, Jan 28, 2007 - 8:08 pm:

I took Moose out for a walk today under saddle for the first time since he was injected. He was a completely different horse. He's always been really quiet and lazy and laid back. Today he was like a 4yr old. He was quite a handful, which he has never been. I don't know if he feels really good or what, but I hope thats it.

It's funny what you said about the chiropractic work. I am not a believer in the field especially with humans, but I was willing to give it a shot with my horse.

Regarding the radiographs, the vet said that he had significant arthritic changes in his right stifle and some in his left too. She said there were abnormalities in the knee cap and femur. Enough to warrant lameness. Although he was sound prior to sinking in the ditch. She didn't call it DJD gosh that makes it seem so much more serious. I know I sound stupid, but I really don't know alot about these things. I don't know the right questions to ask when she gives me this information either. As far as predisposing factors, there are none really. He's never taken a lame step and never been injured. He's never really been worked excessively in his entire life (from what his previous owners said). We jump once a week in a lesson, no higher than 3' and not more than a couple courses. I hack him 3 days and take him on the trails and let him gallop and do whatever he wants 2x a week.

Is there something specific I should ask about his radiographs?
Moderator:
DrO

Posted on Monday, Jan 29, 2007 - 6:32 am:

There is much less support for equine chiropractic work than there is for human chiropractic Melissa. For more on this see Member's Services members_only » The Lounge: Kick back and relax. » Alternative Medicine and Epistemology.

"Significant arthritic changes" on a radiograph would be how you diagnose degenerative joint disease and for a thorough explanation of what DJD is see Diseases of Horses » Lameness » Joint, Bone, Ligament Diseases » Arthritis and DJD: An Overview.

The question you need answered is, "what has happened in my horses stifle". Does your veterinarian feel the "arthritis" is from the injury? And if so, what was injured and how seriously? This is the question that is answered can give you a prognosis. Unfortunately radiographs cannot always answer that question, for more on what type injuries can occur and how to diagnose diseases of the stifle see, Diseases of Horses » Lameness » Diseases of the Upper Rear Limb » Disease of the Stifle » Overview of Stifle Lameness.
DrO
Member:
mysi

Posted on Monday, Feb 19, 2007 - 10:33 am:

A few weeks later and I'm now just as frustrated. I had my horses stifle injected he has improved but still not 100%. So my vet suggested due to his age and breed (draft cross) that it would be beneficial to inject his hocks and sacrum (not sure if I spelled that correctly). I agreed, I figured it would only help not hurt.

That morning I bathed him and he had this huge swollen area on his front right shoulder (the area where I originally felt he was lame). He was very sensitive to the touch there. When she came she said it looked like a bug bite and to use hot compresses and DMSO or poultice. I did that and the swelling went down. Two days later (he was still on rest from the injections) my trainer picked the scab and a "stick" (like from a tree) came out with puss. Later there was still a very hard bump there.

So the same regimen after the injections, three days stall rest and hand walking and back on I went. He was great the first day then the next day he was lame on the front right where the problem was. There was still a very hard bump there but smaller. His spirit was completely diminished and we wasn't eating his grain. He did however eat his hay and gladly took carrots and apples. But his demeanor is what I would interpret as depressed.

I called my vet, she was very concerned, said to give him 2gms of bute a day for three days. With stall rest, and hand walking. I did that, I jogged him yesterday and his front end is back to normal. His hind end is the same, not any worse, maybe a little better. He's eating his grain again and his spirits seem to have gotten back to normal.

My vet says to walk and trot him this week and see if he improves. If not they want me to scan him. I just don't know what else it could be. He's not terribly lame, it's more like he drags his hind end slightly. And they said his inside hip "dips" a little unevenly when he's on the lounge line. I am just very concerned about his comfort level and his general well being.
Moderator:
DrO

Posted on Monday, Feb 19, 2007 - 6:21 pm:

Melissa, sorry to hear about your incident with the stick.

Do I understand your previous post correctly: when the stifle was blocked the horse went completely sound?
DrO
Member:
mysi

Posted on Monday, Feb 19, 2007 - 10:29 pm:

Thanks, I have no idea how that happened with the stick, we don't really have trees around where he is.

Yes, he was sound when blocked at the stifle. After he was injected at the stifle he improved significantly but not 100%. The injections to the hock and sacrum were done more for therapeutic reasons and we thought for sure he would improve completely. And that first day he was 100% sound. Then the next day he was worse, but it was the front end too, which I thought is what made it seem worse.

I worked him tonight and he seemed to be right where he was after the stifle injection. He only shows at an extended trot. Or at the canter which I only did for the vet(he has always been a four beater so you really see it then). I also have him on Adequan his last shot is this Thursday.

My vet is stumped, I guess she thinks it could be soft tissue, ligaments, muscles, something more. I'm willing to do the scan, but I'm not really comfortable with the procedure because of the radioactive injections. I guess it's safe though. She says it's the only sure fire way to figure out for sure whats going on without wasting more time.

It's not like he's 4 and I have so much road ahead with him and can afford to give him 6 months off and see. He's a 14 yr old draft warmblood cross and a big boy at 17.2. He doesn't have alot of jumping left in him, maybe none at this point but I LOVE HIM. He's my first horse and I just don't think I'll ever want to ride again if it's not with him. I just want to do the right thing and I don't know enough to know what that is.
Member:
freshman

Posted on Tuesday, Feb 20, 2007 - 12:42 am:

Melissa, I can understand how worried you are about your boy and want to do the best thing for him. Sure, he isn't a youngster, but at 14 he isn't geriatric either!

Large horse, like large dogs, do seem to "age" more quickly than their smaller counterparts. But he is really only middle-aged, and with good care and a sensible workload, he could easily have 10 years or more as your riding partner. This may or may not include much jumping, but I think that unless his lameness issues become worse, it is reasonable to hope that he continue his level of work with you for a long time.

Six months or some other period of extend rest is not the same as retirement, and I'd encourage you to be open to investing this amount of time into his rehab if recommended. It may be well worth it, and an important part of returning him to work with you like you have always enjoyed.

I just hope that the discussion of arthritis, DJD, etc, hasn't convinced you that the horse is too old to recover. It is somthing that can usually be mananaged quite effectively in most cases. Remember, even very young horses may have arthritic changes at just a few years of age. Doesn't mean that they can't have meaningful careers.

Taking the horse to a referral center for a work-up and bone scan might be your best bet if you are not satisfied with the conservative wait-and-see approach to his issues or just need the most definitave diagnosis possible. Horses undergo nuclear scientigraphy every day, across the world, and it is very safe (if not cheap!). Humans undergo these sorts of medical procedures that involve nuclear medicine a million times, every day.

Good luck with you horse, and don't let the radioactivity involved the scan hold you back. I promise he won't glow in the dark!
Moderator:
DrO

Posted on Tuesday, Feb 20, 2007 - 6:16 am:

Melissa, with you already having localized the lameness to the stifle, scintigraphy would be a waste of time and money, as it is not very specific: if you do get a hot spot, it will not tell you which structures of the stifle are diseased.

To continue to pursue the cause of this lameness better at this point would be to consider either first an ultrasound (use a professional ultrasonography with specialized equipment) and if that did not reveal the cause, diagnostic arthroscopic surgery. For more on this see the article Diseases of Horses » Lameness » Diseases of the Upper Rear Limb » Disease of the Stifle » Overview of Stifle Lameness.
DrO
Member:
mysi

Posted on Tuesday, Feb 20, 2007 - 2:51 pm:

Thank you Kristin for your support and advice. I didn't mean I didn't want to give him 6 months off, I said that because my vet said my options were to aggressively pursue finding out whats going on or I could just give him 6 months off and see if he recovers on his own, but we could still be at the same spot we are now if he doesn't and that's 6 months I would have wasted. I would absolutely without a doubt give him time off if that is what he definitely needed. I'm being told now to walk and trot every day to build back up his strength and I am concerned that I'm doing more damage than help so I feel rushed to make a decision for his well being.

I will do whatever is best for him I'm just so terribly confused to what that is. I'm not one of those people who have been around horses and seen it all. I feel pretty ignorant, like I should know. Unfortunately I am dependant on my vets and trainer and I want to make sure I am not overlooking anything.

I truly appreciate your encouraging words about his age and size. I always seem to get worried about it.
Member:
mysi

Posted on Saturday, Mar 31, 2007 - 2:10 pm:

Well, I HAD A SOUND HORSE!!!!! Several weeks later, corrective hind shoes, Weekly Estrone injections, trotting everyday six days a week increasing 10 minutes a week to one hour now, gymnastics and the first day of catering was last week.

We opted not to scan, as my vet was sure it was soft tissue although nothing showed on the ultrasound and she felt the scan wouldn't really show anything either.

THEN, 2 days ago my horse spooked, tripped somehow and dove head first onto the road. He tore both of his knees open, huge to the bone wounds, tore his face up (road rash). :-(

I called the vet who got to my farm before me and it looks like I have a long road ahead of me cleaning and bandaging everyday. It looks like there was no joint damage, the joint capsule was unharmed but exposed.

Poor guy, all this work and he was fitter than he had ever been now he's going to be stuck in a stall for a while and we'll have to start over!
Member:
quatro

Posted on Saturday, Mar 31, 2007 - 4:46 pm:

OH Melissa, I can feel for you. Levi too spends more down time than horse time. Hope you are ok, I assume you were on board?
I am here if you need company in feeling like a black cloud is above you!
suz & Levi too
Member:
mysi

Posted on Saturday, Mar 31, 2007 - 7:56 pm:

Thanks Suz. Yeah, I'm fine, I don't even remember at what point I came off, it just happened so fast. I don't have a scratch, but I swear I would change places with him.

Fortunately he's a happy horse, he doesn't seem to realize that he's hurt pretty bad.

The black cloud needs to go away. He's my first horse and my trainer says I'm getting a crash course in horse care and injuries.

Thanks again, I'm trying to keep my head up. I don't mind the waiting and starting over as much as I'm feeling bad for him.
Member:
lhenning

Posted on Monday, Apr 2, 2007 - 1:56 pm:

Might be helpful to work on the spooking issue, as this caused both injuries. Sounds like he needs to be de-sensitized to some of the outdoor objects you are near while trail riding so he isn't bothered by normal sounds. Also, he can be taught to spook in place. Do a search on "spooking" and you will find many ideas. Also, the western clinicians like Clinton Anderson and Pat Parelli have good methods for dealing with this. I hand-walked my horse to get him used to spooky things, which is much safer than riding, and it is a good way to build strength while rehabbing.


Good luck and stay safe,
Linda
Member:
mysi

Posted on Monday, Apr 2, 2007 - 2:27 pm:

I've taken Moose out and exposed him to the same things at least 4 days a week. He spooks at the same exact things every time. His spooking is usually no more than swaying to the side a bit or a shake. It's never the things you would think would spook a horse. A truck can fly by him going 60 miles an hour with a parade float hitched to it and he isn't phased. But the same garbage can that he sees every single day seems to bother him. Unfortunately Moose is very clumsy and at 1850lbs, you can't be clumsy without consequences. I will read more information on spooking maybe there's something that will help my overgrown chicken. I appreciate any advice I can get.
Member:
mysi

Posted on Thursday, Jul 19, 2007 - 10:06 am:

I thought I would give an update on Moose. My bandaging (from hoof to chest) every two days, cleaning wounds and lots of TLC paid off. Moose's wounds have finally healed up - still hairless right now but thats ok. I started to get back on him June 1st while he was still in light bandages. Just walking for a while and implemented trotting. Because of the heat I've had to slow down his workout as he is not dealing with the humidity and heat well this summer. He's been bandage free for a week now.

His stifle lameness was resolved 99% before the fall (I hadn't tried jumping yet, hence the last 1%) Now that he's working again he's been sound, but weak. Does great on hard surfaces, but the softer surfaces I can feel he's weak a little in the hind (and LAZY). But like I said we're are leveling off until the heat lifts a bit.

I'm dying to jump again, it's been since the end of November since this all started!!! I've got on a few other horses and jumped but there's nothing more fulfilling than doing it on my own horse.

We've spent the off time bonding more and hanging out. I've really learned so much going through this, so there's a good side to everything. I've learned to stomach cleaning open fleshy gaping wounds (I couldn't even look at that stuff on TV before). I wanted to be the one to take care of him and it's amazing what you can do if you are determined. I can bandage better than my vet now! I can give shots now as well.

I will give another update when we are back 100%
Moderator:
DrO

Posted on Friday, Jul 20, 2007 - 9:44 am:

Thanks Melissa,
It always is good to know how folks are getting along and that you found the silver lining of this cloud.
DrO
Member:
dwinans

Posted on Friday, Jul 20, 2007 - 11:15 pm:

Melissa,

After going through "down times" in the past 6 years with my horse I've come to realize that it's all part of horse ownership. I used to be stressed out and horribly anxious that I was spending all this money on my horse and not even riding him. Now I just do what I have to do to make him healthy again. Things happen - I just have to deal with them. My stress level is much less and I love him just as much. Sometimes I wonder what it would be like to have a different horse - maybe I wouldn't have any health problems - and then I think I would have problems, maybe different ones, but problems nevertheless.

It seems like we work so hard to attain a goal and then have something that sets us back and we are starting all over again. But that's ok - it's not like I'm trying to get to indoors or anything like that. He's my passion and it makes no difference if I'm showing 3'6" or 2'8". We do the best we can.

Keep your chin up!
Member:
hwood

Posted on Saturday, Jul 21, 2007 - 12:05 am:

"It seems like we work so hard to attain a goal and then have something that sets us back and we are starting all over again." -- Dawn

How true, Dawn . . . about life in general, not just horses. A wise woman once said to me, "Holly, I have come to see that life is just a series of adjustments." That doesn't mean we give up our goals and become victims of "FATE," but we do as you do . . . focus on what we love and what is important, and if we come to bumps in the road, we deal with each one as it comes, make needed adjustments, and refocus on what we love. You have a great attitude, Melissa, and have used the experience with Moose to learn things that you never wanted to learn, but will now help other people and horses. Good for you.
Member:
mysi

Posted on Thursday, Aug 2, 2007 - 1:04 pm:

Hi Dr. O, I have a question...

It may or may not have anything to do with my previous issue with Moose's stifle or be significant at all but I'm just being cautious (or neurotic as my vet says) :-)

Moose tends to shift his weight on the hind from side to side quite frequently. He's done this since I got him 2 1/2 yrs ago but it seems like he does it alot more now. I'm not sure if it is just me "thinking" that (because I am so much more aware of everything with him since his injury) but it seems more frequent.

I always thought it was more of an "anxious" behavior because the only time he did it was when he was on the cross ties, when he was in his stall and there was alot going on in the barn or when we were working and I was making him stand still for a long period. My vet agreed with that because it was a continual shift like a kid does when they have to pee (lol). Once he relaxes he stops and stands square.

When I bought him I had the full vet exam including xrays of his legs fetlock, hocks, stifle all which were clean minus minor changes in the hocks and stifle. He's always been sound until my incident in the ditch which started this post. I had his stifle and hocks xrayed after his injury and there were more arthritic changes in the hocks and some in his stifles as well. At 14, and a draft cross, nothing unusual.

He's been sound. We decreased our workout for a bit due to the non sweating but this week we are back to trotting 6 days a week at 60 min. 1/2 walk 1/2 trot. He's very strong on the very firm surface. I started back in the sand ring this week (2x so far)- and it's a medium firm but much softer than the dirt roads and grass trails we have been on. He's definitely weaker in the sand. I feel his hind "dip" here & there and he's much heavier on his feet, but he is also very lazy and unmotivated in the ring (he's always been that way). He's also having to bend alot in the ring and we have been working on staightaways only until now. My vet feels this is normal and he will strengthen once he's working in the sand more frequently.

I guess what I am asking is...Is the shifting a sign of something I may be missing ??? Does it sound right for him to be weaker in the sand?
Moderator:
DrO

Posted on Friday, Aug 3, 2007 - 12:45 pm:

How often does he shift Melissa?
DrO
Member:
mysi

Posted on Friday, Aug 3, 2007 - 1:29 pm:

If you mean frequency like daily or times a day, it's daily and numerous times in the day. If you mean length of rest between shift, it's literally back and forth every 2 seconds. He does it for a minute or two at the most and then relaxes. Then if anything happens, i.e., someone new walks in the barn, horse comes in, goes out, he starts again then relaxes. When he's in his stall it's only when he's looking out his window or stall door and there's action in the barn. When he's eating or busy, he doesn't do it. When he's turned out he doesn't do it. When we are working (out in the ring only) and we stop (like when I stop and chat with someone for longer than a minute) he begins to do it because I won't allow him to move around, he hates to stand still. It never seemed like he did it in his stall before or when we were working, I think thats started over the past few months, or I just never noticed because I really wasn't aware so much with these things until he was hurt.(which is likely, but I can't be sure)

Does that help? Do I sound crazy?
Moderator:
DrO

Posted on Saturday, Aug 4, 2007 - 6:35 am:

Sounds like nervous behavior and not in itself an indication of lameness Melissa.
DrO
Member:
mysi

Posted on Saturday, Aug 4, 2007 - 12:34 pm:

I was hoping you would say that! :-)

Thanks Dr. O!
Member:
mysi

Posted on Thursday, Aug 30, 2007 - 10:18 pm:

And the saga continues....

Three weeks ago I took Moose out on a trail ride. He's been doing great, feeling great and sound. We walked for 30 minutes, trotted about 15, walked and turned around to head home and HOLY COW HE BOLTED. He made it about 5-10 strides before I got him back. It took me a moment to stop laughing as this horse has never had that much spunk. I thought nothing of it and we trotted on home. Next evening I tack him up, take him into the ring, walked around practicing bending and halting to get him to use his hind end more. I go to do the same at the trot and OH NO!!! He's lame. I get off put him on the lunge to see and he looks fine. I get back on, trot - LAME! I decide to give him a couple days off figuring he's very sore from is outburst (he hasn't done anything but trot in 5 months). Three days later, still a little off. The farrier was coming in 3 days and his front shoes are loose and off set (like moved to the side a little). I just gave him off until he was reshod as I thought, one-it could be the shoes, two-maybe he bruised his foot and the farrier can check. Farrier comes, reshods him, can't find any issues in the foot. That evening I come out, put Moose on the lunge line and he's 10 times worse. Called the farrier, he said to give him bute for 3 days and see how he is. I did, he was back to the original lameness after that. Finally my vet could come out (she was in and out of the hospital with Kidney stones). She came out (now two weeks into it). She jogged him and didn't think he looked that off (and he did look better), she felt it was his left hind, I felt it was right front (he was bobbing before, but not when she was there). Flexed him from head to toe - NOTHING! Hoof tested him to death - NOTHING! She thought he was not off enough to be terribly concerned, felt maybe the chiropractor would help and had me put him on Robaxin for 10 days. The Chiropractor came 4 days later (this past Saturday). He felt it was right front. He said Moose had mild something in his right neck (I know I should listen better), and right shoulder. He said last time it was his shoulder and that since he had no "trauma" to the shoulder it was likely that it was coming from the foot, possible heel pain and suggested 3 degree wedges. He thought this also because when we walked Moose up the incline into the barn and when he has to pull himself up on the right front he really struggles. He said Moose didn't want to hyperextend. The Chiropractor called my vet and she called me and said she does not want me changing his shoes without blocking first. Well that makes sense!

So...today was the day...and boy did he come out lame...and he didn't block out even a little anywhere from the knee down on the right front. It's clearly the right front too. So now what??? My vet wants the chiropractor to come back out (who also a very highly recommended lameness vet) and take a second look see if she's missing something. If he cant find anything she's talking about doing a body scan because she says she can spend days blocking joint after joint and spend a fortune and not find a thing, where as with the scan it will do the entire body but unfortunately that may not show anything significant either. Especially due to his build.

Please comment on anything that alerts a comment. My big question is do I go through all of that or give him rest? And for how long would you suggest?
Moderator:
DrO

Posted on Friday, Aug 31, 2007 - 9:43 am:

If I understand the degree of lameness correctly I must say everything from the loose shoe creating trauma and then the progressively worsening lameness as the areas becomes infected suggest a foot abscess Melissa. So why did the lameness not block out? Either it is somewhere else or a block was missed, were they carefully tested by poking the areas desensitized. What did the hoof testors reveal? I would want another exam and if this cannot be localized and it does not improve soon, consider a referral. In the mean time you are dealing with a undiagnosed lameness, see Diseases of Horses » Lameness » First Aid for the Lame Horse.
DrO
Member:
mysi

Posted on Friday, Aug 31, 2007 - 10:29 am:

I completely agree that I wholeheartedly believed it had to be an abscess. The hoof testing revealed nothing, from the farrier or the vet. The tested him on 9/15, 9/23 and yesterday 9/30.

Yes they poked around after being blocked.

He seems to be getting more uncomfortable and his spirits are low. All other vital are good, he's eating fine. My vet doesn't want me to give bute yet until she figures out whats wrong. I do have the other vet (the chiropractor) coming today because he specializes in lameness. (He thought for sure it was the foot/hoof/heal area).

When you say referral I assume you mean Equine hospital. Well, my vet is from there. I use Palm Beach Equine which is the best hospital around that all of the grand prix riders use when here showing during the show season. With that being said, they are also very expensive (everything here is). It's about $120 per block and I had seven done yesterday. OUCH! I don't mind if I'm finding the problem, but I can't afford to keep spending this kind of money with no results. I've spent over $6000 in vet bills since December when this all first started (my savings is gone). I love him so much and desperately want to figure this out and it's killing me to see him even slightly uncomfortable and breaks my heart to see his spirits so low. And considering I can't localize the pain I don't know if I should soak his feet, wrap his legs, apply cold therapy, etc. to make him a little more comfortable.

I will update you later on my vet visit today.
Member:
vickiann

Posted on Friday, Aug 31, 2007 - 1:32 pm:

Have had similar scenarios with two of my horses over the years. In one case it was diagnosed by a farrier as a "gravel" abscess (right in the toe of a front foot, where there was a hoof crack). At the time I was told to soak, etc., which I did. The horse suffered horribly for too long until the abscess finally broke out at the coronet band. The other case, the horse had symptoms of being not quite right off and on for a very long period of time. Finally he became painfully lame. At first the farrier couldn't find anything, though only a few days later it was diagnosed by the Vet. as a sub-solar abscess in the front foot. By then the area was extremely soft and would give to pressure from a finger. When the Vet. tapped on it with a tool it began to drain a bit. This coincided with lots of rain and wet conditions. After the abscess was opened a bit further and drained out, the horse was so relieved, and when it was finally and completely healed and the foot toughened up again, it was as though I had a new horse. Good luck -- hope you get to the bottom of the mystery soon.
Member:
mysi

Posted on Friday, Aug 31, 2007 - 8:21 pm:

So the other vet came out to day and was really baffled that his foot did not block out yesterday, so he wanted to give it another shot. He did, and no change. He hymned and hawed, obviously frustrated, then he decided to block his shoulder joint, just to see if he could rule that out. We waited about 30 min. and jogged him again still terribly lame and then injected the joint. Well...there was a 75% improvement. So he feels that this the area of concern, since he did not block out anywhere in that leg even 1%. I am relieved to know where the pain is coming from. Now we'll x-ray. Only he is concerned due to Moose's size that the x-rays won't be great, but my Equine hospital has state of the art x-ray units so I'll be taking him in.

He said if the x-rays show nothing, we'll inject the joint. And there could be a chip that would have to be removed. He said they can't ultrasound the area but it's not likely any soft tissue issue. He also mentioned arthroscopic exploratory sx.

What are your thoughts on this Dr. O? Is a 75% improvement enough to explore that area or should I be looking for more?
Member:
dres

Posted on Friday, Aug 31, 2007 - 8:48 pm:

Melissa, can you ultrasound first the shoulder joint ..? Maybe bursitis or something like that .. ??

good luck..

On the first day God created horses, on the second day he painted them with spots..
Member:
mysi

Posted on Friday, Aug 31, 2007 - 9:39 pm:

The vet said due to my horses size and muscle mass the ultrasound wouldn't be a great identifier. Bursitis? I have never heard of it. What exactly is that and what are the symptoms? I looked it up on this site but can't seem to find anything that explains it. He has no visible inflammation or pain on palpitation.
Member:
dres

Posted on Friday, Aug 31, 2007 - 11:22 pm:

My mare had low grade lameness on one side, started out as a three year old.. put her out to pasture .. 4 year old still slightly off, bred her put her out to pasture.. 6 year old finally did all the blocking, we guessed, shoulder , so we did the US.. found some fluid in the bicipital bursa.. we injected , gave her the loading dose of Adequan and now every 3 weeks a shot of Adequan,, she has been fine ever since..

On the first day God created horses, on the second day he painted them with spots..
Member:
mysi

Posted on Saturday, Sep 1, 2007 - 7:13 pm:

I really hope it's something that simple. I can live with that. I'm worried it's a chip or something and he'll have to have surgery, I can't imagine putting him through that(I always prepare myself for the worse case). They really don't seem to want to do an ultrasound, but I will definitely ask for one.

Moose is already on Adequan every 2 weeks. We've done the loading dose twice, once in December and again in June. I've been pleased with the results.

Thanks Ann!
Member:
mysi

Posted on Tuesday, Sep 4, 2007 - 12:27 pm:

Dr O I was wondering if you thought that 75% improvement is enough to further explore the area (as explained on 8/31)?

My regular vet is leaning towards a full bone scan instead, which she herself was hesitant about to begin with. I'm so confused.
Moderator:
DrO

Posted on Wednesday, Sep 5, 2007 - 11:56 am:

That is very hard for me to judge Melissa. Basically if this is within the normal range of the lameness, most tend to vary somewhat and some warm out of lameness as they are worked during the exam, I would be suspicious and repeat the test. If this is the best you have seen him look and as the block wore off over the next 30 min to an hour the lameness worsened I would put more credence in it.
DrO
Member:
mysi

Posted on Wednesday, Sep 5, 2007 - 5:16 pm:

My vet wants to reblock him tomorrow before they take xrays. But, I'm concerned of the risks of injecting the joint capsule again. She also says x-rays may not really show anything if the shoulder is the issue and neither will an ultrasound, and she's not so sure the bone scan will help find an issue if it's not the shoulder. I'm very frustrated. He is so clearly lame on the front right and the only improved area was the shoulder. But she's still not sure. He seems to be getting worse.

He goes into the clinic tom., should I be asking other questions???
Moderator:
DrO

Posted on Thursday, Sep 6, 2007 - 7:10 am:

The next question is definitely where is the lameness localized to and regional anesthesia is the most reliable way to answer this. I don't think there is a substantial increase in rate of reactions with another injection.
DrO
Member:
mysi

Posted on Thursday, Sep 6, 2007 - 4:03 pm:

I took Moose to the Equine Clinic today and they reblocked his shoulder joint, same 65-75% change. But again, he does not block out at all anywhere else. They radiographed his shoulder after 6 trys, the best film they got was still not enough to rule out a fracture as there is only one angle they can get it at and they keep saying due to his size, the radiographs are not great quality.

So.....after listening to the vets I opted to do the bone scan. They do it tomorrow morning. I also opted to do the entire body as he previously had hind end issues and I figured since they were going to be loading him up with "glowing drugs", I'd make sure that was all ok too.

They will do the rest of the diagnostics Saturday. Anyway, I will let you know the results then.
Member:
frances

Posted on Friday, Sep 7, 2007 - 7:00 am:

Good luck Melissa. Looking forward to some good news tomorrow.
Member:
mysi

Posted on Friday, Sep 7, 2007 - 10:03 am:

Thank You! - he's being scanned as I type. I'm so nervous. I didn't sleep all night and went to see him at 9:30 last night then again at midnight, and this morning at 5:45 right before they put the "glow stuff" in him, and again at 9:00 when they took him in the room (I'm a little overprotective). Now I'm shut out until it's over at about 1pm. My heart broke to leave him, he wouldn't eat his dinner last night or his breakfast this morning (he did eat some hay). He doesn't like change at all, when we moved barns he was like that for two weeks but at least his friends were there.

He has to stay the night again and they won't let me touch him until tom. Boo Hoo.
Member:
mysi

Posted on Friday, Sep 7, 2007 - 8:11 pm:

So the scanning was finally completed at 3pm. Well, it wasn't the shoulder! It's the RF Elbow joint. It couldn't have lit up more. They say it looks consistent with a fracture. Also, the LH pastern joint is a major concern with them. Then there the T Spine that concerns them too. Tomorrow is the xrays and possible ultrasounds. I'm hoping the LH and spine are only hot from having to compensate weight from the elbow. But I don't even know if that makes sense. I do know since Moose's RF became lame he's held he head VERY low which is very unusual for him. I don't know if that causes strain on that area. They gave me the pictures and I totally see the elbow as an issue as the left is clear, but the hind pasterns both look pretty simular except the LH is a little more solid & defined.

Funny thing (no...these are same limbs of concern from 9 months ago when I first started this post. Now I feel like it's my fault because I've been riding him and probably caused him to breakdown worse. I should have done this back then!

I'll update with the further diagnostics tom.
Member:
scooter

Posted on Friday, Sep 7, 2007 - 9:23 pm:

Poor Moose, at least you are getting to the bottom of his problems. Did they think there was anything they could do for his elbow? I hope the rest of his diagnostics go well.

Hindsight is 20/20 as they say I'm sure if you thought he was hurting you wouldn't have rode him.
Good luck
Moderator:
DrO

Posted on Saturday, Sep 8, 2007 - 8:02 am:

The compensatory idea is really not sensible but then again a hot spot on a bone scan does not always correlate with a problem nor does it always show the problem. Let's take it one at a time and start with the obviously lame leg and the best localization we have. Try and get a second way to confirm the localization if nothing shows up on the imaging.
DrO
Member:
mysi

Posted on Saturday, Sep 8, 2007 - 2:39 pm:

Well...it looks as though Moose has to be retired. They did radiographs on his RF elbow, LH pastern hocks and a couple on his spine. The head vet came in to review the films too. Moose has alot of arthritic changes in his elbow and what they thinks looks to be an old fracture. Pieces of the cup of the joint appear to be missing??? As for the LH pastern, he has what they consider severe DJD. (But he is completely sound there which baffles them). At his T Spine there is an area where 2 discs join that has some changes too, right where it meets the wither.

They did not do ultra sounds as I think they saw enough. They injected his elbow and said to give him 6months to a year and at that point reevaluate to see if I can walk him on trail rides and such. They think with rest his back and pastern should be fine as he shows no discomfort with them right now.(not fine like better, but fine as in no need to inject yet).

They were pretty shocked with his hocks too as they have alot of changes and showed hot on the scan. But they looked at the films from 2 1/2 years ago from my pre-purchase exam and they look the same. (I knew he had arthritic changes when I bought him). Again, Moose has never been lame in any of those areas (except the elbow now and stifles at the beginning of this-which by the way were fine in the scan).

My vet said Moose is very stoic and her concern is that he won't express discomfort until it's too late.

I do wonder something though Dr. O...

Moose's hocks have alot of arthritic changes as they did when I bought him and they appeared hot on the scan too. I had his stifles radiographed back in January and they had alot of changes as well, but they were not hot in the scan. Why does one area appear as hot spots when others with the same problem do not? I've read the pros and cons of the scan, and I am very grateful I did it because I would have never x-rayed his pastern until he was lame in that area or did some real damage. So I saved him that pain I guess. But whats the difference that one appears hot and the other not?

Nevertheless, the vets are pretty baffled at his level of soundness and comfort after viewing the x-rays. They are sending them to New Bolton to the orthopedic specialist to review them. I'm not sure why, but my vet just said this is one of those cases that they just find so interesting.

This is a sad day for me as riding Moose is what I looked forward to everyday. But he is my best friend and he will still be by my side instead of under me for many many years.
Member:
scooter

Posted on Saturday, Sep 8, 2007 - 3:12 pm:

Melissa I am so sorry, I know it is very hard to loose your riding partner. You never know after his rest he may be raring to go....stranger things have happened. Moose is very lucky to have such a caring owner!!
Member:
mysi

Posted on Saturday, Sep 8, 2007 - 4:08 pm:

Thank you Diane. I'm pretty confident with rest he will be raring to go, but my vet said that I still shouldn't ride him. That's were I am a little confused especially after re-reading the DJD info on this site just now. If he's sound, why can't I ride him??? I would absolutely understand if he were uncomfortable, but if he were comfortable would it do him harm to ride?

I guess my vets point is that he never complains and I will be hurting him. I guess I am just grasping for something to tell me I'll be riding him one day and it will not be harmful for him.

I really wish they could talk. Wouldn't that save us so much heartache and confusion???
Member:
dres

Posted on Saturday, Sep 8, 2007 - 4:53 pm:

Melissa , i too have a very stoic gelding.. he has been lame most of his life.. he is 8 years old.. he is my partner for life, he knows it, he trusts me..

Ok this past year as you all know has been vet bills waiting to happen and all my riding horses have been injured / gravely.. Well then steps up my lame gelding.. he has been sound this whole year for me to enjoy and continue my riding education on.. WHY ? who knows.. maybe he just knew i needed him NOW.. I strongly ''feel'' he is being very stoic for me.. yes now and again he takes a miss step, but seems to be fine right afterwards..

So continue with your good care.. you life partner may surprize you..

On the first day God created horses, on the second day he painted them with spots..
Member:
mysi

Posted on Saturday, Sep 8, 2007 - 6:52 pm:

Ann- thank you so much, that gives me hope! It's nice to hear other peoples stories, this site is definitely for horse lovers, not just riders. My vet, whom I adore, she is wonderful and knows I love my horse was pretty matter-of-fact about it, in the most caring way she could be. I guess they see it all and deal with it everyday.

It is amazing how you can bond with one animal. I thought my bond with one of my dogs was unreal until I got Moose, there's nothing like it. I believe he's withstood all that he has since his injury, just to make me happy. I only wish I knew he was probably hurting the whole time. I was riding on the hard dirt roads trotting endlessly for months to build up his stifles, I can imagine what I was doing to his poor arthritic joints.

I keep going through all the what if's...
Member:
shirl

Posted on Saturday, Sep 8, 2007 - 7:33 pm:

Melissa Dear,
Don't "do" the "what ifs". I've spent the past 3 years doing enough of that for both of us,having lost Sierra 3 years ago this Oct. 29. If I'd known then what I know now she may still be with me. She was very strong, willing to bear pain to please and never showed pain till it was too late. You and your friend will be fine, prayers are coming your way.
After a year and a half, fate and Sierra with a little help from Above, I got my Sedona. Keep the faith.
Hugs, Shirl
Member:
frances

Posted on Sunday, Sep 9, 2007 - 7:34 am:

Oh Melissa, I'm very sorry to hear your vets are saying Moose should be retired. As you say, if he's sound it does seem a little strange. Wait and see - maybe after he's been well rested, they will decide light riding will be possible.

Is there another horse you could lease or loan for now? (I know it's not the same.)
Member:
sunny66

Posted on Sunday, Sep 9, 2007 - 12:02 pm:

I'm sorry Melissa, it is heartbreaking, this I know. I agree with Shirl, don't do the what ifs... it'll drive you crazy! I will hope for, at the very least, a light riding recovery for your Moose.
Moderator:
DrO

Posted on Sunday, Sep 9, 2007 - 5:50 pm:

I am sorry to hear about your horse's elbow Melissa.

My guess would be the pastern joint has fused on the badly appearing pastern joint. For more on this see Diseases of Horses » Lameness » Joint, Bone, Ligament Diseases » Arthrodesis and Joint Fusion for Arthritis. For an explanation of how a bone scan works see the subtopic on bone scans in Diseases of Horses » Lameness » Localizing Lameness in the Horse.
DrO
Member:
mysi

Posted on Monday, Sep 10, 2007 - 11:19 am:

Thank you everyone for your kind words and optimism. I am still struggling with all of this. I've accepted the 6-12mo rest, I know regardless that is the best for him and he deserves a break to recoup, and if he isn't better then, I am totally ok with retiring him. He's the love of my life, I would never want any harm to come to him. If he is ok, that's where I am confused as to what his limits are. I know it's a long time away and there no way to tell, I'm just a "over-thinker". I want to know as much information as possible to educate myself on all options, outcomes, etc.

Dr. O,
I've been reading and reading and then reading more...I can't seem to find much information about the elbow joint in horses.

1. Is it uncommon to have arthritic changes in that area, and to go lame from it???

2. Is it possible that him lameness is from tendons? Or anything else? They didn't see a need to ultrasound and I'm starting to worry that I should have pushed for one. After reading your information on diagnosing lameness, it doesn't seem as though x-rays and scanning are that definitive, and vet's over dx x-ray results.

Please tell me if I am grasping at straws here of if I should except their diagnosis.
Moderator:
DrO

Posted on Tuesday, Sep 11, 2007 - 6:24 am:

1) Yes it is uncommon but because it is a high motion joint when present would expect to be painful.
2) Other causes are possible but if remarkable evidence of arthritis in the elbow are present these would be in addition to the lameness from the elbow.

As I cannot examine your horse I cannot make this decision for you Melissa. Would it be possible to post the radiographs that lead to the diagnosis? I would be glad to comment on them.
DrO
Member:
mysi

Posted on Tuesday, Sep 11, 2007 - 9:15 am:

Dr. O,
I have the actual films so I scanned them (I work for a dentist and we have a transparency adapted - but it's small so I couldn't get the entire film and it keeps erroring so they are not of great quality).

I have an outside shot with the leg extended too but they said that one looks fine.

elbow films

elbow 2

elbow 3

elbow 4
Moderator:
DrO

Posted on Thursday, Sep 13, 2007 - 9:55 am:

Hello Melissa,
Sorry for the delay but I wanted to carefully study normal radiographs of the elbow before I replied as I rarely see elbow radiographs. Also the quality of the above images is such that important information could be missing from them and lastly some of my interpretation depends on your statements. I do not want to put myself up as a radiologist or orthopedic specialist, the person who reviewed these may be more knowledgable and certainly had a better viewing situation than I have.

That said I don't see anything to hang your diagnosis of lameness due to DJD of the elbow joint. Yes there are some areas that are suspicious and best seen in the last radiograph:
1) The very irregular margin of the medial epicondyle of the distal humerus. Some irregularity is normal and I do not know if this falls out of the range of normal.
2) The bony proliferative response of the cranio-dorsal aspect of the ulna just behind the same epicondyle.
3) The lipping of the radius in the front of the joint may be in the range of normal lipping that appears here.

However I believe the lipping in the rear of the joint could actually be superimposed irregularities in the ulna (the tall spike near the caudal margin of the joint). The cartilage space of the joint seems normal though the shot somewhat obliqued and if the lesions disappear when the leg is extended what does that say?

I would be interested in the description of the lesions that lead to a diagnosis of DJD. Seems to me you have two choices if you want to pursue this further: block the elbow to see if the lameness refers to here and/or send the radiographs to an equine orthopedic surgeon for review.
DrO
Member:
mysi

Posted on Thursday, Sep 13, 2007 - 12:22 pm:

Thanks Dr. O, I truly appreciate you taking the time to look at the films so thoroughly.

I am going to pick up my films on disc tomorrow and will post the full images.

Honestly, when they brought me in to explain the films, the first thing they said was how bad they were and that I can't keep riding him. After that, I can only make sense of a few words here and there as I was just standing there devistated and very emotional. There are a million questions I have for them and will ask them tomorrow. I do not know why they didn't block the elbow, they were just going by the scan results really. They did say several times that they cannot get great films on Moose due to his muscle mass. I have been waiting to ask my questions because I can't seem to hold my composure to well when I talk about it and I don't want to seem like some over-emotional crazy woman when I speak to them.

I can't seem to bare putting him through anymore than he has. The thought of making him trot again upsets me as they have me convinced that he will never be able to do that again. I already feel like I have done so much harm to him as it is.

I am going to put together a list of questions for the vet, is there anything specific I should be asking?

One thing that I wonder is why they didn't take opposing films? If the other elbow looks the same, is sound and clear on the scan, would that mean we are barking up the wrong tree here?
Moderator:
DrO

Posted on Thursday, Sep 13, 2007 - 8:10 pm:

For me is the question I ask above, what specific lesions do they see that leads to their conclusions. Taking opposing films is not usually necessary to evaluate for DJD if you are familiar with the ranges on normal.
DrO
Member:
mysi

Posted on Tuesday, Sep 18, 2007 - 8:53 pm:

Well, I got the disc, but not with MY horses x-rays, but another horses. I'm getting a new one tomorrow.

As far as DJD, my vet said I misunderstood, but that it's significant arthritic changes, and along with the pastern and hocks it's enough to say I should retire him. Which by the way the hock films look almost exactly the same as the pre-purchase films taken almost 3 years ago (I knew he had changes when I bought him). He explanation is that Moose is going to keep going until he really hurts himself and she doesn't want to see that happen. I don't either. It's just hard to realize his limits when he is so willing and never complains.

I will say Moose is doing better. Very sound at the walk. I will not even try to trot him, I'm am going to give him the rest he deserves. He doesn't try to trot when he's in the paddock and usually when he is off work even for a day the first thing he does is trot around - so I'm taking that he's still hurting. His legs look like they did before his initial injury. I never realized how puffy his legs were from below his knees/hocks to his feet until now. He has always had some wind puffs and I thought he had gotten a lot more but it must have been swelling under the original ones because they are back to what they looked like before.

He's been staying in his stall mostly. I take him out and hand walk him and let him graze for about an hour before I go to work in the early morning and then put him in the paddock in the evening for about 2-3 hours. Unfortunately it's too hot in the daytime to let him out right now and I'm not comfortable yet to allow him out all night. I'm overprotective!
Member:
mysi

Posted on Wednesday, Oct 3, 2007 - 8:54 pm:

Hi Dr. O.

I have my disc with Moose's films and I can open it and view it but I can't copy them to the computer. It's set up on a x-ray viewer program that only allows you to view the files. Is it possible to mail you a copy of the disc?
Moderator:
DrO

Posted on Thursday, Oct 4, 2007 - 9:28 pm:

Hello Melissa,
I do not do private consults of this type and if you want a second opinion on the radiographs you will get far more valuable information forwarding them to a equine radiologist or equine orthopedic surgeon. Universities usually take such referrals. However I would like to know what they say about the elbow radiographs.
DrO
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