|
|
Discussion on Joint Injection to Confirm Diagnosis?
|
| Author |
Message |
New Member:
Spolk
|
Posted on Wednesday, Apr 20, 2005 - 11:39 am:
Hi. I'm the new member who had difficulty accessing the articles after I joined yesterday. Since gaining access, I have tried to absorb as much info as quickly I can, because I have a vet appt. tomorrow and am looking for confirmation on the plan of action my vet and I have decided to take, but I've not seen this M.O. mentioned thus far and thought it wise to just lay it out there for feedback.
I have a 20 yr old TWH that I confiscated from a neglectful owner in January 2004. Stormy was starving to death and had anemia due to severe tick infestation. It has been a long hard road to recovery for both of us, because I do not own land near my home and have had to rely on landowners to aid me in my efforts to rehabilitate my beautiful friend.
Despite all odds, Stormy finally regained most of his weight by the end of October and we went on our first ride. He wanted to run and I let him. He almost fell, caught himself, and began to limp on his left hind leg a couple of weeks later. I learned the hard way that after a horse has been starved, his muscle mass has been depleted and needs to be rebuilt slowly. The vet said the problem appeared to be in his stifle and ordered complete stallrest for a month with daily 15-20 minutes hand walking, steroid treatment for 4 days, followed by a week of Bute. Despite our struggle to keep him eating due to confinement anxiety, Stormy's leg showed marked improvement, so we began light groundwork in the roundpen in January, while continuing stallrest at night. He barely favored the injured leg by the end of January.
Unfortunately at the end of Jan., I had to move Stormy to another location due to a disagreement with the landowner. The stable that I found near my home was very muddy and I think Stormy slipped and reinjured his leg while sorting out the pecking order at his new home. His limp has been much worse this time, in that he does not want to trot and does not put weight on that leg when standing. While he was put on complete stallrest again with Bute therapy, I was unable to do the handwalking for the first two months due to unforeseen circumstances in my household. After a month of stallrest, we had to start letting him out to pasture during the day, because he began losing his precious weight again. His leg has not improved at all this time, so we radiographed it and found a deffinate bone spur on the outside of the femur (right under the spot where the collateral ligament meets the bone) and a possible spur on the tibia (right under the other spur). The hock, pastern, and fetlock joints were all clear of any visible bone degeneration and do not show signs of pain.
The vet shared the x-rays with his partner and another Dr who specializes in lameness and they have concurred that the radiographs and history indicate DJD caused by trauma and/or collateral ligament instability, with the possibility of a cystic lesion that was there in the past, or is still present. He advises to continue daily with low doses of Bute and a joint injection of HA and steroid to further diagnose, saying that if the injection greatly improves Stormy's ability, that would somewhat confirm DJD and if not, we could surmise ligament damage.
Dr.O, do you think the HA and Steroid joint injection is a wise move to further diagnose the problem in Stormy's stifle? I would like to have confirmation to proceed in this plan. Our injection is scheduled for TOMORROW (4/21/05).
Also, will low doses of Bute administered daily hurt Stormy or be detrimental to our efforts to continue weight gain?
In Sincere Gratitude,
Sabrina
|
New Member:
Spolk
|
Posted on Wednesday, Apr 20, 2005 - 2:10 pm:
Dr.O,
Please excuse my ignorance and haste in asking a question that has already been addressed in the article called "Localizing Lameness In The Horse". I see that intra-articular blocks are a common method used to localize and diagnose problems in any joint. To be honest, I had to look up the term "Intra-articular" to realize this is the same thing we are scheduled for tomorrow.
I'm going to go ahead and leave my previous post, just in case you have any words of wisdom to offer me that I haven't found yet.
BTW, I am SOOOO grateful to have found this site! I'm digging it so much that my family members -including myself- are beginning to wonder if there will be life outside of HorseAdvice.com again!
Thanks!
Sabrina
|
Moderator:
DrO
|
Posted on Thursday, Apr 21, 2005 - 8:08 am:
Welcome Sabrina,
Your veterinarians feel they have accurately localized the lesion but are unsure of the nature of the lesion. If there is uncertainty that it is the stifle you are correct: intra-articular anesthesia will confirm the location. But it will not differentiate the cause.
Concerning the bute use, it is unlikely that low doses daily would be harmful but for more on this see, Equine Medications and Nutriceuticals » Anti-inflammatories (NSAID's, Steroids, Arthritis Rx) » Phenylbutazone (Bute).
DrO
|
New Member:
Spolk
|
Posted on Thursday, Apr 21, 2005 - 11:12 am:
Dr O,
Let me make sure I understand what you're saying. Are you telling me that the intra-articular injection will not help us to determine whether the problem is DJD or instability caused by a ligament damage? If this is so, how to you suggest we further diagnose the lameness, if it is indeed in the stifle?
Thank You,
Sabrina
|
Moderator:
DrO
|
Posted on Sunday, Apr 24, 2005 - 1:46 pm:
Right, the article on Overview of Stifle Lameness goes through this pretty thoroughly Sabrina so review the section on diagnosis.
DrO
|
|
|
