|
|
Discussion on Bone Scan and Back
|
| Author |
Message |
Member:
annknigh
|
Posted on Monday, Sep 1, 2008 - 12:07 pm:
Dr. O
I wanted your ideas on my horse's case. He is a 10 year old hannoverian gelding, 17.3 hands. He is having difficulty with his right hind that is most pronounced under saddle. Flexion tests show minimal changes for a stride or two, but when he is under saddle he has trouble bringing the right hind forward and will step short and hop a little at the trot. His trot is better and the abnormality is less after he has cantered, but gradually over time he seems to be getting worse. Xrays of the right hock showed some calcification of the collateral ligament, but the vet didn't think this was causing any problem as was not affecting the joint.
The horse has had trouble for a while with the right hind that one vet thought was weak medial stifle ligaments and he was injected with iodine a few years ago. Over time with work, he improved, but from time to time he would show a shortening of his right hind in the walk.
In January this year, his right hock was injected and the short stride at the walk was resolved. Then about April, he began to do the hopping at the trot, we injected the hock again and it did nothing to help. The hopping would resolve after cantering but over time the frequency of the hopping has increased. He was sent evaluation at a well known vet clinic in Calif, and the bone scan showed two hot spots in his lumbar area, and only a tiny increase in signal over the hock ligament, but nothing else was found. They tried to xray the lumbar area, but they couldn't get a technique that would reveal anything diagnostic due to his size.
The vet injected cortizone into the areas and we are waiting to see if it helps.
I am posting the bone scan results and would like your thoughts on the case. Chemistry panel was unremarkeable, but the albumin was slightly off (cant recall if it was up or down, but the vet didn't think this was remarkeable).
He is doing an EPM test, but I haven't heard the results yet.
I am loading the bone scan images The vet is not sure exactly what is going on or what caused it. He believes the inflammation is at the base of the spinous process.
|
Member:
annknigh
|
Posted on Monday, Sep 1, 2008 - 12:17 pm:
|
Member:
annknigh
|
Posted on Monday, Sep 1, 2008 - 12:21 pm:
|
Member:
annknigh
|
Posted on Monday, Sep 1, 2008 - 12:21 pm:
|
Member:
annknigh
|
Posted on Monday, Sep 1, 2008 - 12:25 pm:
|
Moderator:
DrO
|
Posted on Tuesday, Sep 2, 2008 - 8:23 am:
Hello Ann,
Was a complete lameness exam done including a set of ascending diagnostic regional anesthetic blocks done? What was the description given of the lameness and the results of the diagnostic nerve blocks? Regional anesthesia of the spinous processes might provide conclusive evidence of this being the problem. If this is a spinous processes problem steroid injections are a logical first step.
Concerning general thoughts of back pain as a cause of lameness and treatment modalities see Diseases of Horses » Lameness » Diseases of the Spine, Back & Pelvis » Lower Back Pain in Horses.
DrO
|
Member:
annknigh
|
Posted on Tuesday, Sep 2, 2008 - 5:31 pm:
No nerve blocks were not done, the vet said that there wasn't anything to block as flexion tests didn't reveal anything. He was given steroid injections in the lumbar area, but I will ask about regional anesthesia of the spinous process. Thanks for your help.
|
Moderator:
DrO
|
Posted on Wednesday, Sep 3, 2008 - 6:45 am:
Positive flexion tests are not a prerequisite for doing nerve blocks Ann and the lack of changes with flexions certainly does not rule out lameness in the hoof or leg. All you need for blocks is a observable lameness, like the shortened stride and hop you mention in your first post.
DrO
|
|
|
