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  Discussion on 'Dystrophic Calcification' in both front tendons
Author Message
New Member:
whaka1

Posted on Tuesday, Jun 2, 2009 - 4:12 am:

Hi i am writing this from NZ, and am hoping someone can offer some light/help on this diagnosis...I had the equine vet out to daughters pony last week as she has been lame for 4weeks...the lameness has all but come right but have these weird hard lumps on the back of both front legs...located at top of fetlock but at bottom of tendons with some spongey swelling. After scans & xrays it has been determined that she has old injuries to both tendons that had healed unevenly to begin with & now due to daughter competing her...(jumping higher and more) it has put undue pressure on these tendons & her body has tried to compensate with trying to heal them with bone deposits that have calcified. Today the vet rang and said that she has "Dystrophic Calcification" and is the worst/most unusual case she has ever seen...most of the deposits are floating on top of the tendon with some init...and the other vets there are at a loss as to how or why this is happening. They have requested we bring her in to be scanned on premises so they can get a better idea of whats happening with the better scanner and also to try and work out a 'plan' for her recovery...we know she will never be the athlete she was...and have yet to be determined if she could even be a hack...all depends on how she goes and how she reacts to being brought back after her turn out/recovery period!! So was wondering if anyone else has had any experiences with this...and what was done and how it worked out?? I know that all cases are individual and all reactions to different treatments are too...but any advise/experience i love to hear?? Daughter is absolutely gutted...this is not the only pony she has had with injury issues and its taking its toll on her this time!!
Moderator:
DrO

Posted on Tuesday, Jun 2, 2009 - 7:38 am:

Welcome Bridgette,
Can you tell us exactly which tissues are calcified? From the main gist of your post I would have quessed this is happening within the tendon but you specficially state it is floating on top of the tendon. It also would help if we had an idea of how much calcification has occurred.

Remembering that the calcification is a secondary problem to chronically inflamed tendons it will not be the only problem you deal with but currently rest and a check for a balanced diet especially with respect to calcium metabolism is indicated.

Has there been any history of tiluDrOnate use?

And if the lesions are believed to be causing the problems and the lesions discrete enough has anyone considered shock wave therapy to try and break them down?
DrO
New Member:
whaka1

Posted on Tuesday, Jun 2, 2009 - 3:21 pm:

Thanx DrO...an unsure of any of the answers to your ?s as yet...but am taking "Hope" over to the vets on Friday morning (2 days) as they have requested her over there and they are going to do me a 'deal' as they want to know exactly whats going on!

Will find out which tissues are calcified..and how much!! Will also try and get them to email the xrays to me!

Could you tell me what 'tiluDrOnate' is??..and also would shock wave therapy be like using a tens machine (that pregnant woman use?) as after doing some of my own investigating have been told this might help!

The only other thing that she told me yesterday was the 'degenerative bony changes to the sesimoid bones were mild'

Thanx again...and will get back to you with some further information...Bridgette
New Member:
whaka1

Posted on Tuesday, Jun 2, 2009 - 3:35 pm:

Ohh and she did say that some 'metabolic diseases' can cause this but as she has no other symptoms of these...they have ruled this out!!
Moderator:
DrO

Posted on Wednesday, Jun 3, 2009 - 9:59 am:

We have an article on tiluDrOnate at Treatments and Medications for Horses » Miscellaneous Drugs » TiluDrOnate (Tildren and Skelid) Use in Horses. I think it will be self explanatory.

Post the new information when you get it.
DrO
New Member:
whaka1

Posted on Saturday, Jun 6, 2009 - 12:10 am:

DrO...looks like all is not lost!! The portable scanner they brought to my home was not very accurate at all!! Thank goodness! Her report is as follows...she is also going to email copies of her xrays and scans for my use. So can post them when i receive them!

Reason for hospitalisation:
Scan of tendons and dystrophic calcification. Lameness.

Treatments/Procedures:
Ultrasound Scan - Showed that the calcifications are outside of the tendon sheath and do not involve the tendons. The superfical and deep digital flexor tendons scanned normally. The insertion of the suspensory ligament of the sesamoid bone shows bony irregularity of the bone but for the most part the ligament looks healthy. It is very important that we continue to monitor the swelling over her tendons and she should probably be rescanned or xrayed in 8-10months.

Hope is still lame at the trot both in a straight line and on the lunge. Because of the tendons and ligaments of the leg appear normal the calcification may not be the cause of her lameness, especially as the sound leg is the leg with the most calcification.

Based in this information the fetlock joint was injected with local anaesthetic to see if the cause of the lameness was coming from the joint. This procedure resulted in a 90% improvement in the degree of lameness.

Diagnosis:
Fetlock arthritis, Benign dystrophic calcification.

Ongoing Medication:
Next week will visit Hope in Tauranga and inject her fetlock joint with steriods and hylauronic acid.

Management:
Hope to be on normal paddock management, though i would not recommend having her on steep ground for now.

Hope can have next week off. After her joint is injected she can be brought slowly back into work. For the first week she can be walked under saddle for 30-40min per day. The next week introduce some trot work. 20min walking then alternated 20-30 seconds of trot and 1-2minutes of walking for a further 5-10minutes. After this if she stays sound she can be brought back into full flat work. We will need to reassess her before we consider any type of jumping work.

OK...does this sound ok?? Vet was very nice and she is from USA...just making sure all basis are covered!!

Thanx again...Bridgette
Moderator:
DrO

Posted on Sunday, Jun 7, 2009 - 10:25 am:

Was the fetlock radiographed Bridgette?
DrO
New Member:
whaka1

Posted on Sunday, Jun 7, 2009 - 7:11 pm:

Hi DrO...'radiographed'...ummm we had the fetlock joint, sesamoid bone and partial cannon bone xrayed and we also had the tendons ultra sound scanned...is either one of these what you mean??

Thanx Bridgette
Moderator:
DrO

Posted on Monday, Jun 8, 2009 - 8:11 am:

Yes radiographed = xrayed. Radiography is the name of the procedure when you use xrays to image tissue. What did they find in the fetlock?
DrO
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