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  Discussion on Bony changes on front of P2
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Member:
Lexi

Posted on Thursday, Apr 14, 2005 - 4:08 pm:

I have a 12/13yr old cob mare who I have owned for 7yrs who has over the past 6 months or so been less willing than usual. Her symptoms are that she always strikes off on left canter lead even on right rein circle and will often remain in counter canter rather than self correcting. She has always stumbled in walk or trot but I put it down to being on forehand and lack of impulsion/laziness. She finds it harder doing lateral work, side pass, turn on haunches to the right. She takes a shorter stride with left hind on both reins. She is stiff and tense on circle to the right with a higher head carriage and nose pointing out of circle. When I ask for trot/canter she shakes her head or snakes neck as strikes off especially on right rein. She doesn't really 'use' her hind end and is occasionally disunited in canter (right). She carries her head left of centre on a straight line in trot. She stops dead from trot/canter the moment you ask her to slow down. She always stands with her hind legs tucked under in front of the vertical with off hind usually further under - her front legs are often behind the vertical so giving her an almost triangular stance. She has lost more weight than usual and felt the cold this winter so maybe in ongoing low grade pain. She has also developed a tendency to bolt as if scared swinging her head to side (mainly left)as if scared of something behind - although of course this could be unrelated and behavioural!She also tests positive to near hind flexion test.
She is not head bobbing lame - maybe grade 2 apparent on a small circle on hard surface. At first the vet thought it was her off fore/near hind diagonal but on the next occasion her near fore showed worse. She was nerve blocked (PDN I assume as she was shaved either side of pastern above heel bulb)and when her near fore was blocked she showed lame on her off fore and stumbled when first asked to lunge. When both are blocked she moves much better and her hind end also looks freer. After this the vet suspected navicular so x rayed her front hooves but there didn't appear to be changes to navicular bone (viewed through another bone?)or coffin bone or joints. Her pasterns were then x rayed and there were changes to the surface on the front of both left and right P2 pastern bones (middle) but worse on the left one. Again no obvious degeneration of joints.Other things were that her pedal bone was a bit flat almost parallel to sole rather than 10-15 degree angle. The vet suggested the bony changes may be a bit like splints in that they are painful while forming but may settle and that the stumbling may be due to the extensor tendon catching on the changes. Her left hoof is slightly out of balance which could account for impact not being absorbed up the leg? She does have a spanking trot and extravagent action. He recommends egg bar shoes so that the hoof hits the ground strainght not 1 side 1st which could aggravate the tendon on the bony changes and is giving her NSAID weekly injection for a month which also has cartilage protecting qualities. He says to continue working her to keep blood flow to bones but I am concerned that the extensor tendon may be involved as the changes appeared to be around the site of attachment. There is no obvious heat or swelling so how can I tell if what was found on x ray is actually what is causing her gait changes as on one hand exercise will help and on the other if soft tissue is the cause I could make things worse? I have read that changes as on her x ray can be apparent without lameness so may not be the cause especially as I thought this area was above the PDN block. I'm sorry for going on but does any of the above throw any light on what could be wrong or what further tests/treatment to ask for? I also got the impression that if the tendon was involved (mineralised?? - how can I tell?)then prognosis was poor so exercise was recommended on the chance that it isn't.
Thanks for any help.
Moderator:
DrO

Posted on Friday, Apr 15, 2005 - 8:09 am:

The history above illustrates a common problem, lameness that resolves to the foot often cannot be diagnosed in the field. The next best step Jo is going to be a nuclear magnetic resonance scan done on the foot, for more on this see, Equine Diseases » Lameness » Diseases of the Hoof » Overview of Diagnosis and Diseases of the Foot.
DrO
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