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Discussion on Mare lame with swelling and heat in right front knee
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Member:
lilo
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Posted on Tuesday, Dec 15, 2009 - 12:06 pm:
Hi DrO and all,
My 23 year old mare came up severely lame in her right front leg. She was fine on Sunday, on Monday morning she stood in her paddock, holding her right front leg in front of her and periodically touching her nose to her knee joint. Extremely reluctant to move, but could support her weight on the right front. Swelling on knee joint and above, warm to the touch.
I fed her right were she was so she would not have to move and called my vet. He came in the early afternoon and checked her out (vital signs normal, appetite normal) and palpated the right front knee joint and vicinity. The most extreme pain response was found on palpating the radius right above the joint. He gave bute intravenously and returned later with the xray unit and took numerous xrays (one of them with the leg flexed). Instructions to give 2g of bute twice a day, and cold hose the joint twice or 3 times a day.
This morning he called with his findings: no fracture or chip found. Rough spots on the bone indicative of arthritis, not unusual for a horse her age. He saw a lump at the end of the radius that concerns him - in dogs this is a common location for bone cancer.
This is my question: DrO, in your experience with many, many horses over the years, have you ever encountered bone cancer in this location? We have no idea how the horse could have injured herself - she has not been turned out with her stable mate in probably 10 days and has her own paddock and stall. Her paddock still has some ice at the lower edge due to the last snow storm but my vet feels the site of the "injury" is to high on the leg to be consistent with a fall.
My instructions are to continue the bute (2g twice a day, she weighs about 1100 lbs) and cold hose the leg twice, preferably three times per day. The bute has made a tremendous difference in her comfort level.
Thanking you in advance for your response,
Lilo and Moonlight
P.S. I have read several of the articles, interpretation of radiographs, diseases of the upper front limb, and reviewed the diagram of the bones of the front limb. How great it is to have this recource.
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Member:
scooter
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Posted on Tuesday, Dec 15, 2009 - 5:56 pm:
Hi Lilo, sorry to here about Moonlight, hope Dr.O can give you some insight. I almost have to think since it came on so strong overnight it has to be some sort of acute injury, especially since bute makes it feel better.
Not much help am I.
Good Luck
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Member:
lilo
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Posted on Tuesday, Dec 15, 2009 - 7:42 pm:
Diane - I hope you are right. All my horse friends seem to feel the way you do, that it acts more like an acute injury.
There is no outward sign of any injury, the cold hosing is just to try and get the swelling down. So far it has not made a difference.
Keeping fingers crossed,
Lilo
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Member:
mrose
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Posted on Wednesday, Dec 16, 2009 - 12:15 am:
Hi Lilo. I agree with Diane, for what it's worth. I would think (great vet that I am ! that if it were cancer the pain would come on more slowly. The only way I can think of that cancer would cause sudden lameness would be if the bone was so weakened that it broke. Since the vet didn't see any break or chips, I would think that could be ruled out. I've had knees and fetlocks on horses over the years that got either banged or tweaked somehow and suddenly were swollen. The worst was a fetlock that a horse banged on a pipe panel when trying to kick another horse. I thought for sure it was broken. The horse wouldn't put weight on it and it got very swollen. At the vet's advice I cold hosed and gave bute, and the leg was fine, but it did take a few days for the swelling to go down.
Dr.O might correct me on this, but if there is no open wound, I'd think you could try DMSO without a wrap, or cold hose, apply cool gel, and wrap. An old time trainer told me to wrap with Saran wrap under the pressure wrap, but not to leave it on too long. Do it between the cold hosing.
Always something! Hang in there. Hope you're not as cold as we are here; hosing might be difficult if you are.
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Moderator:
DrO
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Posted on Wednesday, Dec 16, 2009 - 6:46 am:
Hello Lilo,
No I have never seen bone cancer in this location and bone cancer is quite rare in the horse anywhere but the nature of the radiographic changes should be the key focus when trying to rule in or out this diagnosis.
Hot painful swelling just proximal to the knee would include trauma and carpal extensor tendon rupture as likely possibilities. As long as the swelling is warm I would prefer the use of ice/water packs (frozen peas or corn in plastic packages also work well) under bandages but if you use a chemical substance it may not be best to cover it as it can cause irritating reactions in some cases. It really depends on what the substance is so hard to make general recommendations.
DrO
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Member:
lilo
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Posted on Wednesday, Dec 16, 2009 - 9:43 am:
DrO, Thank you so much for your response. Having lost one horse to cancer, that possibility had me worried.
I will try to get the area chilled with ice packs or frozen peas - I had already thought about that, since the cold hosing is messy and afterward she wants to roll, even though I dry her leg afterward.
The problem is the location - I would probably have to wrap the lower leg so I could somehow keep the cold pack in place. Off to search the bandaging techniques and forums - I know I have seen suggestions on HA.
If there is no improvement in the swelling, my vet suggested an ultrasound and possibly a digital xray, in case he missed a hairline fracture. I am still very puzzled as to how she could have injured that location. This is the horse that will go down on her knees and stick her head under the fence to get at a blade of green grass ....
Thanks again,
Lilo
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Member:
lilo
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Posted on Wednesday, Dec 16, 2009 - 9:48 am:
Sara - thanks for your response. I definitely think that more diagnostics are indicated if this does not resolve soon. As I told DrO, I need to figure out how to cool that area without going through the mess of cold hosing.
Moonlight once popped a splint by trying to kick the gelding next door - healed up fine and never took a lame step! Horses!!!!
Stay warm,
Lilo
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Member:
lilo
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Posted on Friday, Dec 18, 2009 - 11:45 pm:
Update on Moonlight: The vet came out yesterday (17th Dec) and examined her again. I saw the xrays and he explained them to me. The lesion on the radius is about 1 inch above the knee joint and can be seen quite clearly. However, seeing how much she had improved he did not feel that we were dealing with a tumor (again, based on his experience with dogs). So - now we are thinking soft tissue injury.
I am to continue the cold hosing and give bute (1g, twice a day). He will come back next Wednesday, and hopefully by then she will be a lot better. Fingers crossed. This is hard on her stablemate, since I keep him in his smaller paddock so she won't start running the fence. The swelling is coming down, but still quite significant. If only horses could talk ....
Lilo
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Member:
canter
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Posted on Saturday, Dec 19, 2009 - 9:27 am:
I hope she continues to improve, Lilo.
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Member:
lilo
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Posted on Saturday, Dec 19, 2009 - 9:55 am:
Thank you, Fran. The swelling is continuing to go down, although the lower leg is stocked up. For that reason the vet prefers that I do the cold hosing rather than cold packs - so the entire lower leg is cooled down.
Lilo
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Member:
canter
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Posted on Saturday, Dec 19, 2009 - 1:45 pm:
That the swelling continues to come down, to me, is a good sign, although don't be surprised if there is a set back or two. As we all know, horses can be their own worst enemies when it comes to "babying" an injury.
Can you wrap her legs to prevent the stocking up?
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Member:
leslie1
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Posted on Saturday, Dec 19, 2009 - 2:49 pm:
continued healing prayers for your mare Lilo
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Member:
vickiann
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Posted on Saturday, Dec 19, 2009 - 5:05 pm:
These kinds of things can be so frustrating.
Good luck with having steady progress, Lilo
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Member:
lilo
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Posted on Saturday, Dec 19, 2009 - 11:43 pm:
Thank you all for your positive thoughts. She is making steady progress and after hosing her today I decided not to wrap her lower leg - it is almost back to normal. It is going to get very cold soon, sure hope I can stop cold hosing then.
Lilo
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Moderator:
DrO
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Posted on Sunday, Dec 20, 2009 - 7:56 am:
Hello Lilo,
Delighted to here things are going so well but how is the lameness doing? Did the veterinarian label the radiographic changes ot the soft tissue swelling?
DrO
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Member:
lilo
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Posted on Sunday, Dec 20, 2009 - 10:49 am:
Hi Dr. O,
I have seen all the radiographs - they are not digital, unfortunately. The lesion that had him concerned so much initially, actually coincided with the most significant swelling. The best I could do would be to show were the lesion was on the skeletal images on this website. Or - I could try to take digital photos of the radiographs.
Her lameness is much improved - at a walk she seems normal. Initially she was quite tentative at the walk. I have not tried to trot her, since rest is part of the treatment. I am sure my vet will want to check her at a trot at the next check-up. We did not do an ultrasound.
Vet knows that as a retired person I need to try to keep costs in line. If she had not improved so quickly, I would definitely sprung for more diagnostics.
Lilo
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Member:
scooter
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Posted on Sunday, Dec 20, 2009 - 3:05 pm:
Lilo glad to hear Moonlight is improving so quickly Those old girls are tough!
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Member:
lilo
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Posted on Sunday, Dec 20, 2009 - 8:15 pm:
Thanks, Diane. Moonlight has been remarkable in terms of staying sound - but, I definitely believe she is IR - like your guys.
While I don't trot her on purpose, she volunteered a trot today as I led her out in the back yard to do the cold-hosing. Just a few steps - seemed OK on the straight line.
Lilo
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Member:
mrose
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Posted on Sunday, Dec 20, 2009 - 9:24 pm:
Hi Lil0; I'm so glad that Moonlight continues to improve! Her trotting a few steps shows she's feeling a lot better. Continued best wishes for you both.
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Member:
lilo
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Posted on Friday, Dec 25, 2009 - 11:52 am:
An update on Moonlight: The vet check on December 23 showed nor more swelling or pain response upon palpating. However, I was warmed that she might still be a little sore coming off the bute. We did not check for lameness at the trot (snow everywhere) but she walked out just fine.
Need to keep her in her paddock for a about a week longer, as well as keeping her pasture mate close. I would not turn out on pasture right now anyway - snowy now and when the snow melts it gets very slick. We are still in the dark about the lesion on her radius, but I will watch her closely for any future problems.
Lilo
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Member:
scooter
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Posted on Friday, Dec 25, 2009 - 10:03 pm:
Good News Lilo. keeping fingers crossed moonlight continues to improve
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Moderator:
DrO
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Posted on Saturday, Dec 26, 2009 - 9:20 am:
Thanks Lilo.
DrO
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