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  Discussion on Obscure lameness after second neurectomy
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Member:
krampric

Posted on Sunday, Oct 21, 2007 - 4:40 pm:

My horse had a first neurectomy in both front feet in March this year, after two years of increasingly persistent and severe lameness and thorough examinations. Before surgery, he had become sound through nerve blocks in the navicular region. However, he remained lame on his left foot after surgery, and this lameness disappeared when nerve block to navicular region was applied. My vet concluded that my horse must have an unusual nerve branch which was not caught with the first operation, and carried out a second neurectomy higher up in July. The horse became sound in walk, but remained very uncomfortable in trot, however without clear location of lameness in a particular leg. The fetlock was enlarged and the tendon sheath above swollen and hot. The vet said that the swelling is due to fluid not being absorbed after two operations in the same area, and recommended light exercise (riding him in walk), turning him out, cold hosing of the leg etc. I did all this for several weeks, but there was no change. This week he became very lame again on the left leg without apparent reason. I have now decided to put him on box rest and to see if this leads to improvement. Could it be that something different is going on? Should I get a second opinion?
I would be grateful for advice and ideas.
Anne Marie
Moderator:
DrO

Posted on Monday, Oct 22, 2007 - 8:13 am:

Hello Anne Marie,
I am a bit confused by the posting above as exactly what blocks were given and exactly what the results were is unclear. But in short if a ring block applied at midpastern does not relieve the lameness you have something else going on and the hot, swollen tendon sheath, known as tenosynovitis, sure seems suspicious. Has he considered infection in the sheath? You can read more about the diagnosis and treatment at, Diseases of Horses » Lameness » Diseases of the Lower Limb » Flexor Tendinitis.
DrO
Member:
krampric

Posted on Monday, Oct 22, 2007 - 11:43 am:

Dear Dr O
Thank you for your quick reply. I'll try to clarify as best as I can. The nerve blocks before both neurectomies, according to the vet, were given specifically to see if the neurectomy would work. I saw him injecting the nerve block very low into the pastern, between the bulbs of the heel as far as I could see. He is as puzzled as I am that the neurectomy in the left foot doesn't seem to have worked the first time, and what the "stiffness" after the second neurectomy was all about. I must confess that I haven't consulted him yet about the recent lameness this week. The swelling and the heat has gone down now after some days of box rest, ice and bandaging, but the horse is still lame on two Bute (Danilon) a day. I am inclined to continue this regime as it seems to work,and I'll read your article on tendinitis.
My main question is if there is any hope that the horse can return to some kind of work, even if it is only light hacking. If you any further thoughts, please let me now!
Many thanks
Anne Marie
Moderator:
DrO

Posted on Tuesday, Oct 23, 2007 - 9:05 am:

Hello Anne
In your particular case we don't know what this "new" problem is exactly so we really do not know the prognosis but I don't see anything that gives you no chance. To really answer the question we need a accurate diagnosis.
DrO
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