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  Discussion on Capped hock
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Member:
swancott

Posted on Wednesday, Jul 8, 2009 - 4:01 am:

My four year old, 17.1 hd Appaloosa gelding turned up with a mild capped hock last April while he was at a dressage training barn. The trainer didn't think he was lame so she kept him on his three day per week work schedule with pasture turnout on the off days. After a few weeks of hot/cold hosing, bute and ice wraps the capped appearance went away. We thought he may have gotten the injury from hitting his stall wall while rolling, so I had extra shavings added and spread more evenly so he wouldn't have a tendency to get too close to the walls when lying down. His stall was large (16 x 20) and had Comfort stall mats which are fairly soft and there was an attached paddock which consisted of firm dirt. He was also being turned out in a large paddock/pasture several times a week for several hours.
After his hock looked normal for a couple of weeks, the trainer came back after the weekend and he had traumatized it again only this time it was bigger than before. She started the hosing/bute/ice routine over again, but this time the whole hock became extremely swollen and we couldn't figure out what he was doing to cause it. I called my vet and she told us to stop doing any work and just hand walk him for a week along with what we were already doing and see how it did after a week and half. We put him in the pasture at night by himself with another horse in the pasture next door and then back in his stall during the day so we could monitor his behavior and make sure he wasn't injuring himself in some way. We never observed him doing anything out of the ordinary to cause the injury. It continued to get worse, becoming curby looking, so I had the barn's vet come out to do x-rays, etc. She did a lameness exam and he was slightly lame on hard ground. The x-rays showed no trauma to the bone or tendon attachment, so she prescribed Surpass, rest and ice for two weeks. After that it was better but was still pretty cappy looking with mild intermittent lameness on hard ground.

I took him out of training and brought him home and put him in 1/4 acre paddock with soft sand to lie down in. I had my vet come out and she recommended continuing the Surpass and using a wrap at night, which I did. After another week of Surpass, he still had the capped appearance, so I asked her to come out and we did additional x-rays and an ultra-sound. None of the underlying structures looked damaged, so at this point she recommended leaving it alone for a week to make sure the skin wasn't being irritated. I did that and it seemed to get a little bigger, so she told me to wrap it at night again with the neoprene wrap to see if it would sweat down. That improved it a little, but every time I take the wrap off for any length of time, it seems to get more prominent.

It's now been two and half months of this and I'm afraid this is going to be a permanent blemish. It's also frustrating because I think the horse may be re-injuring it somehow when he gets up and down, although I've watched him get down to roll and then get up and he doesn't do anything differently from how he did it before the injury and his hocks were fine. He went through a late growth spurt when I put him into training just about the time he got the capped hock the first time in April. After being nearly level front to back, he shot up an half inch at the butt and became gangly and uneven, like he was as a two year old, only MUCH larger (he weighs 1400 lbs. and is built like a warmblood).

My questions are these: Could a dramatic growth spurt where the bone outgrows the soft tissue cause or exacerbate a capped hock? Could the simple act of getting up and down for such a big animal cause a capped hock or keep it from healing? Also, when do you assume the the swelling is permanent? Could it still get better given enough time? I'm trying to be sure I don't give up prematurely and that I'm doing everything I should to minimize any permanent effects.

Thanks, Vanessa
Moderator:
DrO

Posted on Wednesday, Jul 8, 2009 - 7:23 pm:

Hello Vanessa,
Taking your questions in order:
1) No I don't believe so.
2) We are talking about the flexor apparatus, so yes it is possible getting up and down, which stresses this may be somewhat aggravating.
3) There is no particular time frame but when the edema turns to scar it is permanent. Ultrasounds can help make this determination.
4) The fact you can get it to go down suggests it will get better if you keep working hard to get the swelling out. So keep that wrap on but do all you can to be sure it does not irritate the skin.
DrO
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