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  Discussion on Volar pouch of the fetlock joint - heat and swelling
Author Message
Member:
dxangel

Posted on Tuesday, Jul 7, 2009 - 5:09 pm:

Hello Dr O,

I am writing again in regards to my Dutch Horse, in the UK who is currently being rehabbed for compression of P3 and poss lameness due to old OCD LH.


Things have been going quite well, the horse has been sound with his current medication, however after a 2 day rest i noticed this evening the volar pouch of the fetlock joint was swollen - looks like a windpuff and i have seen windpuffs on this horse before.

However, this one is LH unilateral, has a small amount of heat and the horse appears to be slightly lame at trot - only visible by the dip at the hip. Having not trotted the horse up for the past 2 weeks, i cannot say if this lameness is new or just so slight it has gone unnoticed.

The swelling itself can be pushed from side to side. Palpation of the area elicits no response.

The horse is already on 2x NSAIDS am/pm so cold hosed, but did not bandage as i want to be able to see if the swelling gets worse.

Obviously the vet will be contacted in the morning, however i would like to hear your opinion as to wether this sounds like a windpuff or something more serious given the small amount of heat and possible lameness.

I have attached a picture of LH resting his foot as the swelling is more visible.

fetlock
Moderator:
DrO

Posted on Thursday, Jul 9, 2009 - 8:04 am:

Hello dxangel,
Swelling of the volar fetlock joint pouch is much more obvious when weight bearing and not when flexed. When you flex the fetlock lots of the supportive structures behind kind of bunch up so looking at the above photo, I cannot tell what is normal bunching, unusual shadow, and pathological swelling.

We were traveling yesterday so I did not get to all the posts. Of course the lameness is the main concern so I am interested in what the veterinarian said.
DrO
Member:
dxangel

Posted on Thursday, Jul 9, 2009 - 2:27 pm:

Hi Dr O

I hope you enjoyed your travels, and thank for you getting back to me when you can.

Enclosed is a picture i took today, i apologise for the bad quality.

Treatment past 48 hours:

Stable bandage legs 24x7
cold hosing 20m 2x day,
box rest

Results:

The swelling has not gone down much, but is much more 'squidgy' ( technical term that! ) and much less hard than 48 hours ago.

I finally got to speak to the vet on the phone today, he is not able to make it out until tuesday.

His treatment advice:
- stable bandage at night
- cold hose 20m 2x/day
- warm kaolin (clay) poultice at night under stable bandages
- turnout during the day.

I am guessing he is playing it safe with hot and cold treatment, however i am worried about turnout if he has somehow done a tendon.


I would love to know if this looks like a windgall to you, or something more sinister.

windgall
Member:
dxangel

Posted on Thursday, Jul 9, 2009 - 2:32 pm:

Hi again dr O,

ive just realised that that picture really is bad quality and i have managed to locate another one, taken 48 hours ago, when he is fully weight bearing.

wpuff
Moderator:
DrO

Posted on Sunday, Jul 12, 2009 - 9:09 pm:

I continue to remain a bit in the dark about the swelling you are talking about. I do think the first weight bearing image shows a mild volar pouch distension and a mild flexor sheath distension. Neither of these are a clear indication of a problem and you can read more about them both in the article on fetlock diseases. For help identifying the swelling see the images at Diseases of Horses » Skin Diseases, Wounds, and Swellings » Swellings / Localized Infection / Abscesses » Diagnosing and Assessing Swellings in Horses.
DrO
Member:
dxangel

Posted on Monday, Jul 13, 2009 - 5:10 pm:

Thank you Dr O, you have answered my question - i wanted to make sure i was on the right track in terms of identifying the swelling

Swellings are bilateral and im now sure they are not the cause of the horses lameness. After 5 days rest the horse trotted sound today, i believe they call this sods law, as the vet is due tomorrow and im sure he is not interesting in looking at a sound horse.

He has been lunged tonight, then while i was cold hosing him i found a splint LH. i am hoping this could be the cause oh his current lameness, but we will have to see tomorrow.
Member:
vickiann

Posted on Monday, Jul 13, 2009 - 8:35 pm:

I want to thank you, Dxangel for posting these photos and questions and also thank Dr. O for his response.

This has been extremely informative and educational.
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