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  Discussion on Extended lameness
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New Member:
Aacrs

Posted on Saturday, Aug 16, 2003 - 5:37 pm:

I have a 11 yr old mare, who in the spring I found out on pasture with her two pasture mates early one morning. They had been on dry lot all winter, and should not have been on pasture yet. When I lead them off the pasture, the mare was lame. She exhibited no heat or swelling. I assumed they had acted like "free horses" and she had perhaps twisted an ankle. That was nearly three months ago. WE have treted for an abscess, did a couple nerve blocks. (The lowest block make no improvement, the second block, given in the front up a little higher than the first, did provide for some improvement.)_ X-rays showed no injury. I waadvised by my vet to put her on rest and give her MSM. She has been in a restricted area (not stall bound however), but with marginal improvement. I took her for second opinion a little over a month ago, and was told continue rest and MSM, - give her 8 more weeks. I feel like I am not being agressive enough in finding treatment. But two vets have basically told me the same. I confered with the first vet this week, who says, pretty much, more rest probably isn't going to help and could n't tell me what it might be that would be treatable if we investigated more. I am thinking maybe fx that didn't show up on early radiographs. Mare spends most of her time as a pasture ornament, as she is my "now married" son's horse and seldom ridden, But is a well bred, well trained ride. What to do??? Any suggestions??
Thanks
Moderator:
DrO

Posted on Sunday, Aug 17, 2003 - 9:09 am:

A troublesome problem and fairly well described Dayla. I need an accurate description of which blocks have been done and what the exact results. Have 2 different sets of blocks both had the exact same result? If so have you had a recent set of radiographs done and have several different sets of oblique views been done? Radiographic signs of disease are sometimes not picked up unless caught just right.
DrO
Member:
Aacrs

Posted on Monday, Aug 18, 2003 - 10:51 pm:

From looking at the diagram on this site that shows typical nerve block sites, I would say he blocked A/navicular and then B/coffin jt or possible B/coffin jt and then c/pastern jt. I will be checking with the vet's office to get better information and find out exactly which views he obtained on film. Films were taken with a small portable unit which the vet hand held to take the films. will see what I can find out. Thank you!
Member:
Aacrs

Posted on Wednesday, Sep 3, 2003 - 9:50 pm:

My vet tells me he did ant/lat views of ankle ant/lat/oblique of the knee. He did "palmer/navicular" nerve block and one above the fetlock The palmer/nav block made no observable difference in her limp. the second was a signficant improvement, but not complete. Any suggestions as where to go from here are appreciated.
thanks
Moderator:
DrO

Posted on Thursday, Sep 4, 2003 - 6:42 am:

Your vet took a short cut skipping the abaxial sesamoid block leaving open the question whether the lameness is in the pastern or ankle. I would do the abaxial sesamoid block and if that did not relieve the lameness block the ankle joint. This gives a different set of rule outs than the low volar nerve block (the block above the fetlock). My next step depends on the results, the article on Diagnosis lays out a step by step plan with links to related articles, we have one on both pastern and ankle diagnosis.
DrO
Member:
Aacrs

Posted on Thursday, Sep 11, 2003 - 9:27 pm:

well, I have read the article and if had to pick would lean towards a pastern injury. I am certain my vet will not do any further blocks, he has pretty much said as much. He also told me of bad outcome he had with taking one of his horses to our university large animal clinic with nerve blocks. So, I am wondering if there is signficant risk to doing more blocks? Is there much that can be treated without some type of surgery. If I am correct in thinking that she had made a very slight improvement - maybe 5% with in the first 8 weeks, she may have made that much more improvement so perhaps she is 10% - 20% at most, improved. She does not have a huge alteration in gait, but it definetly is there. The second opinion vet talked about doing imaging with contrast next - I also wondered if there is value in doing an ultra sound to rule out soft tissue damage? I am located in Central Illinois and really only know of UofI clinic as an option for more advanced care. Would it be preferable to find someone local willing and capable of doing the block before heading to university clinic? We do have some race horses in the area, and my farrier can put me in touch with vets who care for those horses. I may proceed in that direction. Thanks for infor and will update you
Moderator:
DrO

Posted on Friday, Sep 12, 2003 - 7:23 am:

Nerve blocks are very safe. The idea of pursing much more invasive and expensive diagnostics like contrast radiography before doing a simple and useful procedure like a abaxial sesamoid nerve block is .... just weird.
DrO
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